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r
K.HIIll. . IIADCL.
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jR o r^
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THE
MEDICAL WORKS
OF
PATJLUS iEGINETA,
T H K a II K R K P H Y S I CI A N.
TRANSLATED INTO ENGLISH:
WITH
A COPIOUS COMMENTARY,
COXTAIKINC
A COMPRPMIENSIVE VIRW OF THK KNOWLKDGK POSSKSSKI) liV THE
CiREEKS ROMANS, AND ARABIANS. ()N ALL SUBJPXTS
CONNECTED WITH MEDICINE AND SLRCJERV.
VOL. L
By FRANCIS ADAMS, Esq.
SURGEON,
AUTHOR OF <<nKKME8 PJIILOLOCrS," &<•.
*' Multum egeruut qui ante nos fueniiit, sed nun peregenint. ^NUspicieiuU tuiiieu
sunt, et ritu Deonim oolendi." — Sknkca.
LONDON:
J. WELSH ; TREUTTEL, WURTZ. & CO. LONDON ;
ADAM & CHARLES BLACK, EDLNTBURGH ;
HODGES & SMITH, DUBLIN;
AND A. BROWN & CO. ABERDEEN.
MDCCCXXXIV.
ABERDKRN :
I'RIXTED BY G. CORNWAIX,
HERALD OFFICF.
INsrniBKD TO
JOHN ABERCROMBIE, Esq. M. D. Edinburoh,
ANU
G. J. GUTHRIE, Esq. Surgeon, London,
IN TESTIMONY OF
ESTEEM FOR THEIR LITERARY AND PROFESSIONAL CHARACTERS,
AND OF GRATITUDE FOR THE FRIENDLY INTEREST
WHICH THEY HAVE TAKEN IN THE PRESENT PUBLICATION,
BY THEIR OBLIGED AND FAITHFUL SERVANT,
THE EDITOR.
Ban<hoby-Terxam, Nov. 12, 1833.
THE EDITOR'S PREFACE.
Notwithstanding ihe efforts which have been made of late years to im«
prove the Medical Literature of this country, it will still be admitted, I am
convinced, that there is not, in the English language, any work which con-
tains a full and accurate account of the Theoretical and Practical knowledge
possessed by the Greeks, Romans, and Arabians, on all matters connected
with Medicine and Surgery. Nor, as far as I can learn, is the case much
different with the Continental languages; for, altliough the German and
French have lately acquired several Histories of Medicine distinguished
for considerable ability and research, the object of all these works would
appear to have been confined to a general exposition of the leading disco-
veries and revolutions in doctrine which marked every particular age or
epoch in the profession; and I will venture to atfirm that no person will be
able to acquire from a perusal of them any thing like a competent acquaint-
ance with the minute detail of ancient practice. The design of the present
publication is to supply this deficiency, by giving a complete Manual of the
Surgery and Medicine of the Ancients, with a brief but comprehensive out-
line of the sciences intimately connected with them, especially Physiology,
the Materia Medica, and Pharmacy. At first it was my intention to do this
in the form of an original work, but, being perplexed with the multiplicity of
matters which I had to treat of, I at last resolved upon taking for ray text-
book the celebrated Treatise of Paulus JEciklta, whereby I was at once
supplied with a convenient arrangement of my subject, at the same time that
I enriched our Medical Literature with the translation of one of the most
valuable relicts of ancient science. By following this correct and faithful
guide — ^by supplying his omissions and enlarging his plan, when necessary —
yi THE KDIT0R*8 PREFACE.
and by adding, in all cases, the improvements of several subsequent ages — I
trust that I have been able to present the reader with a work from which he
may, at one view, become familiar with the prevailing opinions of the pro-
fession upon all the most important points of Medical Practice during a
period of more than fifteen centuries. Impressed with the importance of the
task which I had undertaken, I have endeavoured to discharge it faithfully
to the best of my ability ; and have, therefore, overlooked no Treatise con-
nected in anywise with the Medical Art which has come down to us from
antiquity, and have further availed myself freely of the learned labours of a
number of modem Commentators, especially on the department of the Ma-
teria Medica, in order to adapt the nomenclature of the ancients on these
subjects to the present state of Botany, Chemistry, and Mineralogy.
As to the original authors from whose stores I have drawn so freely, un-
less I am much blinded by partiality for the pursuits in which I have been
lately engaged, they will be found, upon an intimate acquaintance with them,
to have been well entitled to the confidence and reputation which they long
enjoy«i], and to which it is my wish and hope that the present publication
should, to a certain degree, restore them. It appears to me that, at certain
periods of ancient times, the standard of professional excellence was such as
would not easily be attained at the present day with all our vaunted im-
provements iu education ; and that many of these early masters of our Art
were distinguished for varied stores of erudition, an ardent love of truth, and
an aptitude to detect the fallacies of error, such as few of us even now can
lay claim to. The Father of Medicine held that, to become an eminent phy.
sician, it was necessary not only to be well acquainted with the structure of
the human frame, but also to be skilled in Logic, Astronomy, and other
Sciences; and of him it may be asserted, that he sought after scientific truth
upon the strict principles of the Inductive philosophy more than two thousand
years before the world gave Lord Bacon the credit of introducing this me-
thod of philosophizing. His devoted admirer and follower, Galen, was
evidently the very beau ideal of an accomplished physician — skilled in all
the sciences of the day, in Logic, Mathematics, Rhetoric, and the First Phi-
losophy;— to all these ornamental branches of knowledge he added a minute
THB bditoh's prkpack. ri\
acquaintaoce with Anatomy and Physiology; a practical experience with
the phenomena of diseases as diversified by climate, situation, and the Ta-
ried modes of life; a singular perseverance in collecting facts; and an extra-
ordinary ability for generalising them. The cotemporaries of Celsus declare
of him that he was not only well acquainted with Medical Literature but
also minutely skilled in every elegant and useful science which was known
and cultivated at that remarkable period. And Rhases, the Arabian, requires
of bim who aspires to eminence in the Medical profession, that, instead of
wasting his earlier years in frequenting musical and drinking parties, he
should have spent them in conning over the valuable records of ancient wis-
dom. ^ But the Sciolist," says he, '* who gives himself out for a proficient
in the Art, while be has scarcely even a smattering of learning, will never be
deserving of much confidence, nor ever attain any great eminence in his
profession. For it can never be that any individual, to whatever age he may
reach, should be able to comprehend in his mind a subject so vast and dif-
fuse, except by treading upon the footsteps of the ancients ; since the boun-
daries of the science far exceed the narrow limits of the life of man, as is the
case with most of the liberal arts as well as with Medicine. The number of
authors is not small by whose labours the Art has attained its present
growdi ; and yet one may hope to master the monuments of their industry
within the space of a few years. Let us suppose that, in the course of a
thousand years, a thousand authors had made improvements in the profes-
sion ; and then a person who has diligently studied their works may im-
prove his mind as much in knowledge as if he had devoted a thousand years
to the study of Medicine. But, when an acquaintance with former authors
is despised, what need be expected from the efforts of a single person ? For,
however much he may surpass others in abilities, how is it to be supposed
that his private stock of knowledge should be at all worthy to compare
with the accumulated treasures of antiquity ? In a word, he who has never
turned over the pages of the ancient physicians, nor has formed to his mind
a distinct conception of the nature of diseases before he enters the chambers
of the sick, will find that, from ignorance and misapprehension, he will con-
viii THE editor's prkfack.
found one complaint with another, for this obvious reason, tltat he has come
to his task unprepared and uninstructed /'
The reader will not fail to remark, in the course of his investigations, that
there is no legitimate mode of cultivating Medical Knowledge which was not
followed by some one or other of the three great Sects into which the profession
was divided in ancient times. The Empirics held that Observation, Experi-
ment, and the application of known remedies in one case to others pre-
sumed to be of a similar nature, constitute the whole art of cultivating
Medicine. Though their views were narrow, and tljeir information scanty,
when compared with some of the chiefs of the other sects ; and, although they
rejected, as useless and unattainable, all knowledge of the causes and recon-
dite nature of diseases ; it is undeniable that, besides personal experience
they freely availed themselves of historical detail, and of a strict analogy
founded upon observatiort and the resemblance of phenomena. To this
class we may refer Scribonius Largus, Marcel lus, Plinius Valerianus,
and a few others, frequently quoted by us. The sect called the Rational,
Logical, or Dogmatical, holding that there is a certain alliance and con-
nexion among all the useful and ornamental arts^ maintained that it is the
duty of the physician not to neglect any collateral science or subject.
They therefore inquired sedulously into the remote and proximate causes of
diseases, and into the effects of Airs, Waters, Places, Pursuits, Food, Diet, and
Seasons, in altering the state of the human body, and in rendering it more or
less susceptible of morbid changes. Looking upon general rules as not
being of universal application, they held that the treatment ought to be mo-
dified according to the many incidental circumstances under which their pa-
tients might be placed. They freely and fully availed themselves of whatever
aid they could derive from Experience, Analogy, and Reasoning. Hippo-
crates, Galen, Aetius, Oribasius, Paulus iEgineta, Aetuarius, and all the
Arabian authorities, may be looked upon as belonging to this sect. The Pneu-
matic sect, to which Aretseus belonged, was nearly allied to the Dogmatic.
The sect of the Methodists, rejecting altogether the consideration of remote
causes, which they held to be of Tio importance to the cure, and giving them-
selves up lo too bold a classification of diseases, according to certain hy()o-
THK editor's PRSFACK. Ix
thetical states of the body in which they were supposed to originate,
fettered themselves too much with a few general rules, which they held to be so
universally applicable, that they would scarcely allow of their being modified
by incidental cirrtumstances in any possible contingency. Notwithstanding this
defect, it is undeniable that their speculations as to the nature of diseases are
generally very acute, and their modes of treatment frequently very rationaL
Upon the whole, the general outline of their system would appear to have
borne a striking resemblance to that of the sect which started up in Edin-
burgh about forty years ago, called the Brunonian, from the name of its
ingenious but fanciful founder Dr. Brown. The only perfect model of ai»-
cient Methodism that has come down to us is Cslius Aurelianus, an author
so truly eminent that some of his admirers in modern times have not scrupled
to maintain that his works are even better worth being attentively studied
than those of Hippocrates and Galen. Moschion, and Theodore Priscian
otherwise known by the name of Octavius Uoratianus, likewise belonged to
this sect ; Alexander of Tralles also had a considerable leaning to its princi-
ples ; and some would even refer the illustrious Celsus to the same class ; but
this author would seem to have imbibed the genuine spirit of Eclecticism,
and, like his distinguished correspondent Horace, to have been
ti
Nollius addictus jurare in verba magistri.*'
Before concluding these Prefatory remarks, it will be naturally expected
that I should say something of the author whose work I have bestowed so
much pains in translating and commenting upon. Here, however, I must
regret that the information which I have to supply is exceedingly scanty and
unsatisfactory. So little is known of him that it is not even ascertained in
what century he flourished. Vossius is wholly undecided; Moreau and Le
Clerc place him in the fourth century; Vander Linden and Conringius, in
the fifUi ; but Freind, Albertus Fabricius, Hutcheson, Sprengel, and most of
the late writers of the Ancient History of Medicine, bring him down as low as
the seventh century, upon the authority of Abulfaragius ; an author, however,
who, on many occasions, betrays such gross ignorance of chronology that no
X THB EDITORS PRBFACK.
reliance ought to be put on any opinion of his on these matters. What con-
fidence does a writer deserve who states, for example, that Andromachus,
the physician who added the flesh of vipers to tlie celebrated Electuary of
Mithridates, lived in the time of Alexander the Great ! — that Dioscorides of
Ain Zarba flourished in the reign of Ptolemy Physcon, namely, about 120
years before Christ, whereas it can scarcely admit of a doubt that the cele-
brated author of the Greek Materia Medica did not live earlier than the end
of the first century of the Christian jEral — and that Ruff'us was coteraporary
with Plato, when we have the authority of Suidas that he lived in the reign
of Trajan I Dr. Milward, in his Epistle to Sir Hans Sloane, endeavours to
settle the age of our author from the following train of inferences : — In the
first place, then, since Paulus quotes Trallian, and Trallian, Aetius, it is quite
certain that our author was posterior to both these writers. Now the age
of Aetius may be made out from the following circumstances: — Aetius
mentions St. Cyril, Archbishop of Alexandria, whose death is ascertained
from Ecclesiastical History to have happened as late as the middle of
the fifth century. Nay, he also takes notice of a medicine much recom-
mended by Petrus Archiater, chief physician toTheodoric, who was posterior
to St. Cyril. We cannot possibly suppose it likely, then, that Aetius flourish-
ed earlier than the end of the fifth century. But what brings him still further
down is the circumstance of his predecessor, Trallian, being mentioned by
Agathias, the Historian, about the year 565. It would seem almost certain,
therefore, that our author cannot have lived at an earlier period than the end
of the sixth or the beginning of the seventh century.
But, whatever may have been the period at which he lived, there can be no
doubt that he attained great eminence in his profession, and continued to be
looked up to as one of the highest authorities in Medicine and Surgery dur-
ing a long succession of ages. His countryman Nonnus, although, if I recol-
lect right, he does not mention him by name, gives a brief compendium of a
considerable portion of his work ; and Psellus does the same in Leonine
yerses. All the medical authors, in a word, of the distinguished Arabian
period, quote his opinions in almost every page of their works, and never
fail to recognise him as one of the most trust-worthy of their Grecian masters.
THB editor's prbfacb. xi
At the revival of Litei^ture in modern times, the Latin Translations of the
Arabians continued for a time to be the ordinary guides to practice ; but
when the superior merit of their Greek originals came to be properly appre-
ciated, our author rose again into high consideration. As a proof of this, t
may mention that the Surgery of Fabrice d'Aquapendente is made up almost
entirely from his works. Portal, therefore, had no good occasion for repre-
senting him as '' one of those unfortunate writers to whom posterity had not
done justice.*' I admit, indeed, that for some time past, since professional
research and the study of ancient models have been superseded by a restless
desire of novelty in Theory and in Practice, he has not enjoyed that considera-
tion to which he is justly entitled ; but, in this respect, he has only shared
the fate of other names, equally eminent for their contributions to Medical
Science, who have now been suffered to fall into neglect.
Of the Latin Translations of his works, the most celebrated is that of Cor-
narius, published by Henry Stephens in his Medica ArtU Principts ; but
which, af^er a careful examination, I have not found to be so trust-worthy as
I expected to find it. There once existed an Arabic Edition by Honain, a
Syrian Physician, but of it I know nothing. The only part which has been
translated into any modem language is the Sixth Book, a French Translation
of which was published at Lyons, A. D. 1539. Of the Original there are
two Editions, namely, the Aldine of 1528 and the Basle of 1538, neither of
which is so accurate as could be wished.
To many individuals and literary bodies my best thanks are due, for the
facilities which they afforded me of consulting certain scarce books, which
otherwise I should have found difficulty in procuring access to. I feel par-
ticularly indebted to ^. H. Barker, Esq. of Thetford, not only for assistance
rendered to me in this way, but al&o for much important advice on many
points connected with classical literature.
Banchory-Tehkak,
November 12, 1833.
PAULUS iEGINETA.
THE AUTHOR'S PREFACE.
It is not because the more ancient Writers hail omitted any tiling leialive to
the Art that I have composed this Work, but for the purpose of giving a
compendious course of instruction. For, on the contrary, every thing is
handled by them in a proper manner, and without any omissions, whereas the
modems have not oAly in tiie first place neglected the study of them, but
have also blamed them for prolixity. VVherefore, I have undertaken the fol-
lowing Treatise, which, as is like, will serve as a Commentary to those who
may choose to consult it, whilst it will prov« an exercise to me. For it appears
wonderful that Lawyers should be possessed of compendious, and, as they
call them, popular legal Synopses, in which are contained the heads of all
the Laws, to serve for immediate use, whilst we neglect these things, although
they have it generally in their power to put off the investigation of any point
for a considerable time, whereas we can seldom or rarely do so ; for in many
cases'necessity requires that we act promptly, and hence Hippocrates has
proi>erly said, "The season is brief." For their business is generally con-
ducted in the midst of cities, where there is an abundant supply of books,
whereas physicians have to act not only in cities, in the fields, and in desert
places, but also at sea onboard of ships, where such diseases sometimes sud-
denly break out as, in the event of procrastination, would occasion death, or at
least incur the most imminent danger. But to remember all the rules of the
healing art, and all the particular substances connected with it, is exceedingly
difficult, if not altogether impossible. On this account, 1 have collected this
Epitome from the works of the ancients, and have set down little of my own,
except a few things which I have seen and tried in the practice of the art. For
being conversant with the most distinguished writers in the profession, and
2
in particular with Oribasius, who, in one work, gave a select view of every
thing relating to health, (he being posterior to Galen, and one of the more
modem authors,) I have collected what was best in them, and have endea-
voured, if possible, not to pass by any one distemper. For the work of
Oribasius, comprehending 70 books, contains indeed an exposition of the
whole art, but it is not easily to be procured on account of its bulk, whilst
the epitome of it, addressed to his son, Eustathius, is deficient in some dis-
eases altogether, and gives but an imperfect description of others, sometimes
the causes and diagnosis being omitted, and sometimes the proper plan of
treatment being forgotten, as well as other things which have occurred to my
recollection. Wherefore, the present work will contain the Description,
Causes, and Cure of all diseases, whether situated in parts of uniform tex-
ture, in particular organs, or consisting of solutions of continuity, and that
not merely in a summary way, but at as great length as possible. But in
the first place, we will give an exposition of every thing that relates to Health
and Regimen. The last book contains an account of simple and compound
Medicine?.
CONTENTS
or THK
WHOLE SEVEN BOOKS OF THIS WORK.
In the First Book, you will find every thing that relates to Hygiene, and to
the preservation from, and correction of, distempers peculiar to the various
ages, seasons, temperaments, and so forth. Also, the powers and uses of the
different articles of food, as we have explained in a summary manner.
In the Second is explained the whole doctrine of Fevers, an account of
certain matters relating to them being premised, such as excrementitious
discharges, critical days, and other appearances, and concluding with certain
symptoms which are sometimes the consequences of fever.
The Third Book relates to Topical affections, beginning from the crown of
the head and descending down to the nails of the feet
The Fourth Book treats of those complaints which are external and ex-
posed to view, and are not limited to one part of the body. Also, of Intes-
tinal Worms and Dracunculi.
The Fifth treats of the Wounds and Bites of venemous Animals ; also of
the distemper called Hydrophobia, and of persons bitten by dogs which are
mad, and by those which are not mad ; and also of persons bitten by men.
Among other things, it treats of deleterious substances, and the preservatives
from them.
In the Sixth is contained every thing relating to Surgery, both what re-
lates to the fleshy parts, such as the extraction of weapons ; and to the bones,
which comprehends fractures and dislocations.
In the Seventh is contained a description of the Properties of all Medi-
cines, first of the simple, then of the compound ; particularly of those which
I had mentioned in the preceding six bo<^s, and more especially the greater
and, as it were, celebrated preparations. For I did not think it proper to
treat of all these articles promiscuously, lest it should occasion confusion,
but so that any person looking for one or more of the distinguished prepara*
tions might easily find it. Towards the end are certain things connected with
the composition of medicines, and of those articles which may be substituted
B 2
for one another, the whole concluding with an account of weights and mea-
sures. We proceed to the First Book.
In this the First Book, as we stated in the Preface, and as will be described
afterwards more particularly, is contained an account of every thing relating
to the preservation of Health. We shall only premise, that in the 1st and 2d
Books almost every thing is taken from Oribasius. For I mean not to seek
after fame for myself, but to collect what is useful from all quarters. In the
remaining five Books, little or nothing is borrowed from him.
HEADS OF THE FIRCT BOOK.
1. On the Complaints of Pregnant Women, and their Regimen.
2. On the Nurse.
3. On the Milk of the Nurse.
4. How to correct bad Milk.
5. On the Nurture of the Infant.
6. On the Eruptions which happen to Infants.
7. On the Cough and Defluxion of Infants.
8. On Pruritus of the Skin.
9. On Dentition..
10. On Aphtha, orThrush.
11. On Excoriation of the Thighs.
12. On Watery Ears.
13. On Siriasis.
14. The Diet of Infants, and of the succeeding ages, until manhood.
15. On the Preparatory Friction.
16. On Exercise.
17. On the kinds of Exercise.
18. On the kinds of Friction.
1 9. On Vociferation.
20. On Lassitude from Exercise.
21. On Constriction of the Skin. .
22. On Spontaneous Lassitude.
23. The Diet of old Men.
24. For Rugosity of the Body.
25. To make the Perspiration fragrant.
6
26. To Warm the Habit.
27. For Paleness.
28. On Lividity.
29. Preservatives of the Teeth.
30. To prevent Dullness of Hearing.
31. On Dimness of Sight.
32. On Repletion.
33. On Intoxication.
34. On Corruption of the Food, or Dyspepsia.
35. On Venery.
3(5. On Impotence.
37. On Inordinate Venery.
38. On Redundance of Semen.
39. On Congelation.
40. On Sun- burning.
41. On collections of Phlegm in the Stomach.
42. How to produce easy Vomiting.
43. On Laxatives and Diuretics to those who are in Health.
44. On Clysters.
45. On Suppositories.
46. On Medicines which evacuate the Head — on Masticatories, Errhines,
and Liniments to the Nose.
47. On Emmenagogues.
48. On Sudorifics.
49. On Airs.
50. On Waters.
51. On Baths.
52. On the natural Baths.
53. On the Regimen fitting to the different Seasons.
54. On the Regimen of Persons in Business. 'm
55. On the Regimen of Travellers.
56. On the Regimen of Persons at Sea.
57. On diminishing Obesity.
58. How to recruit those who are Emaciated.
59. How to recruit parts which are Emaciated.
60. How to know the best Temperament.
61. How to know the Intemperaments of the Body.
62. On the Form of the Head.
63. How to know the Temperaments of the Brain.
64. How to know the Temperaments of the Stomach.
65. On the Temperaments of the Lungs.
66. On the Temperaments of the Heart.
67. On the Temperaments of the Liver.
68. On the Temperaments of the Testicles.
69. On the parts that are omitted.
TO. On tlie Cure of (he Hot IiileLuperameiLls <rf ibe Body.
71. On the Cure of die Cold [iitemper:im;nts of ihe Body.
73. On tlie Cure of ihe Dry Tutenipcramenls, as of the Stomach, for <
xmple. Then of ihe other In temperaments.
73. On the Powers of the Articles of Food.
74. On Pot.Herbs.
75. On Asparagi, or Young Slioots.
76. On Escotent Roots.
77. On Tiuffles and Moshrooms
78. On different kinds of Com,
79. On Pulae.
80. On the Fugacious or Summer Fruits.
ei. On the Fruit of Trees.
82. On Animals; and, Srst, of Fowls.
B3. On Eggs.
84. On Beasts.
85. On the parts of Animals.
86. On the Milk and filood of Beasts.
87. On the Dnnking of Milk.
88. On Milk that has been separated into part^i.
8Ih On Cheese.
■ 90. On Fish.
91. On the Crjstacea.
OS. On theMollusca.
03. On (he Cartilaginous Fishes.
04. On tbe Cetaceous Fishes.
95. On the Properties of Wine.
96. On Honey, and honied Water or Mead.
97. On Sleep.
98. On Watcbfulnefs.
99. On Somnolency.
100. Diocles' Epistle on the Preservation of Health.
PAULUS iEGINETA.
BOOK FIRST.
I. — On the Complaints of Pregnant TVomen and their Diet.
Of the complaints which hefal women in a pregnant state, since
the most trouhlesome are a redandance of crudities, continued vo-
miting, salivation, pain at the cordiac orifice of the stomach, and
loathing of food ; it will not be improper to give directions regard-
ing them. The most suitable remedies are, exercise on foot, food not
too sweet, wines which are yellow, fragrant, and about five years old,
and moderate drink. All these things are proper for the cure of cru-
dities and vomiting. For medicines, you may give the bloodwort,
boiled in water, for drink ; and likewise dill, and the Pontic-root,
called Rha, in the dialect of that country. These things may be
taken at the time of eating, or before it. Externally, the flowers of the
wild vine, those of the wild or domestic pomeg^nate, the leaves of
the alsanders (smymium), and the seed of the fennel, may be mixed
together along with dates and old wine, and applied to the prsecor-
dium in the form of a cataplasm. Pains at the orifice of the stomach,
may be alleviated by drinking warm water, by gentle exercise on
foot, and by covering the hypochondrium with soft wool. To those
who have an aversion to food, you should recommend a variety of
articles of a savoury nature, and also dry starch. This last is par-
ticularly applicable to those who long to eat earth, as is the case in
the complaint called pica, which occurs most frequently about the
third month after conception ; because the foetus being then weak,
cannot consume all the aliment which is brought to the uterus, and
hence the superfluities are collected in the stomach. Wherefore, they
have a desire for complicated and improper articles, such as burnt coals,
Ciraolian earth, and various such things. On that account, the af-
fection has got its appellation, either from the variety of colours
which the bird pica possesses, or from its being subject to this com-
8 • PAULUS yliGINETA.
plaint. Labour and long journeys will also contribute to restore a
desire for wholesome food. But she who has accustomed herself to
live in an indolent manner, will not be able, when she proves with
child, to bear exercise all at once. To those who loathe food, it
may be of service to take acrid substances, and particularly mustard.
For swellings of the feet, it may be proper to bind over them the
herb anthyllis, soaked in vinegar ; or to lay the leaves of a cabbage
over them, and to anoint them with Cimolian earth mixed with vine-
gar, or with alum and vinegar. It is likewise of use to wash the
feet with a decoction of the Median apples, called citrons.
II. — On the Nurse,
A NURSE is to be chosen who is free from every complaint, and is
neither very old nor very young. She ought not to be less than
than twenty-five, nor more than thirty-five. Her chest should be
large, as also her breasts, and her nipples neither too prominent nor
too much retracted. Her body should be neither very fat nor very
spare. It is of great consequence to the child that his nurse should
have brought forth not long before, and that her child had been a
male. She ought to avoid every thing of a very desiccative nature,
and likewise such as are saltish, acrid, sour, acid, bitter, very heat-
ing or of an offensive smell ; also, such as are strongly fragrant,
cx)udiments, and such like acrid substances. Let the nurse also ab-
stain from venery. Let her work with her hands and shoulders,
let her labour at the mill and the loom, and carry about the child
in her arms. This may be done even when it is three or four months
old.
III. — On the Milk of the Nurse.
The best milk is that which is moderate in thickness, quantity,
colour, smell, and taste. It is a proper way to try the quality of the
milk, by pouring a little of it upon the nail of the thumb and ob-
serving it in the sun ; for, when upon turning the nail, it neither
runs off too slowly nor too quickly, it is good milk. You may also
try it thus, by pouring some milk into a glass vessel, and putting
some runnet into it, then stirring it about with your fingers, allow
it to coagulate, and observe whether the cheesy part be less than
the serous : for such milk is not good, and also the opposite
kind is of difficult digestion. The best kind is that which has a
moderate proportion of each.
IV. — How to correct the bad qualities of Milk,
Thb bad qualities of milk may be thus corrected. If it be too
thick, the phlegm ought to be evacuated by vomits, the most pro-
BOOK FIRST. 9
per of which, are those of vinegar and honey. It is also proper to
extenuate by labour before eating. Also, the following substances
may be given : — namely, wild marjoram, hyssop, savoury, shep-
herd's needle, thyme, a little radish, and old pickle with vinegar
and honey. But if it be more acrid and thinner than natural, the
nurse ought to be relieved from labour, to be fed upon strong soups,
and the flesh of swine, and drink sodden must and sweet wine. If
it be in too small quantity, she ought to get soups and a generous
diet, with sweet wine for drink. And let her breasts and nipples
be rubbed. The cupping- instrument, if applied, will also be of ser-
vice. That medicines for the formation of milk, are possessed of
some efficacy. I am well aware, and yet I do not recommend them
in all cases, for they speedily waste the body. They are the root
and fruit of the fennel boiled in ptisan, the leaves of the citisus in
dark-coloured wine or ptisan, the sweet gith (melanthium) , dill,
the root and fruit of the carrot. They are to be first soaked with
warm water, and then given. But when the milk is bad, whether it
be thick, acrid, or of a strong smell, it is first to be sucked out, and
then the child is to be applied. Por that which is acrid, ought on no
account to be given to the infant when hungry ; but that which has an
ofiensive smell, may be corrected by fragrant wine and sweet food.
Of coagulated milk in the breasts, we will treat in the Third Book.
V. — On the Nurture of the Infant.
The first food given to a new-born child should be honey, and after-
wards milk, twice, or at most, three times a-day. When it appears
disposed for it, and seems able to digest it, it may get some food, care
being taken not to stuff it. If this should happen to be the case, it
will become more sleepy and inactive, there will be swelling of the
belly and flatulence, and its urine will be more watery than natural.
When this is observed, it ought to get no more food until what it has
got be consumed. The child may be brought up upon milk until it
be two years old, after which, its diet may be changed to food from
grain.
VI. — On the Eruptions which happen to Children.
Whatever eruptions appear upon the skin of a child, are to be
considered, in the first place, as a good indication ; but when the
eruption is properly come out, it may be cured, by putting the child
into baths of myrtle, or lentisk, or roses, and then anointing with the
oil of roses or lentisk, or with a cerate containing ceruse. And its
body may be gently rubbed with nitre, but it will not bear hard
friction. But the best plan of cure, is for the nurse to live upon
f-weetish things. And the child's diet ought to be attended to, so
that it be neither too full nor too spare. If the child's belly be consti-
pated, a little honey may be put into its food ; and if even then it do not
10 PAUL.US JiGlNETA.
obevi turpentine, to the size of a chick-pea may be added. When
the belly is loose, millet in particular ought to be ?idministered.
VII. — On the Cough and Defltixion of Infants.
Whbn the child is seized with cough or defluxion, recourse is
to be had to a Linctus of honey. Its head is first to be bathed with
warm water, and plenty of honey given ; then press its tongue
gently with your finger, and it will vomit up much phlegm.
VIII. — On Pruritus of the Skin,
If the child be seized with pruritus, use fomentations, and anoint
him with plenty of boiled oil, in which a little wax has been melted.
IX. — On Dentition.
The teeth begin to g^ow about the seventh month. At that
time inflammations of the gums, cheeks, and tendons are apt to
occur ; and sometimes convulsions. The child must then get no-
thing which requires mastication; and you should rub his gums
frequently when in the bath with your finger, or soften them with
the fat of fowls or the brain of a hare. When the teeth are just
coming through, you may wrap the neck, jaws, and head in soft
wool, or they may be anointed with warm sweet oil, some of which
ought to be poured into the pores of the ears. The child ought then
to have a more generous quality of food, and be bathed in warm water.
If he have diarrhoea, you must try to bind his belly by epithemes,
or external applications of an astringent nature, such as cumin, dill,
or parsley, sprinkled upon wool. It is proper to mix the seeds of
roses, and, in short, to use all d^siccants. If the bowels are consti-
pated, they may be gently roused to action by means of a suppository
of honey, or the belly may be rubbed with mint mixed up with honey.
But the best remedy for the convulsions of children, is to bathe
them in water wherein tumsol (heliotropium) has been infused. It
will be of consequence also to use the oil of privet, of the iris, and
the Secyonian oil ; and, in short, every thing which is of a calefa-
cient nature. But when the teeth have come through so as to bite
the fingers, it may be proper that he keep in his mouth the root of
the iris, shaven down and not quite dried. This also is of use to
ulcers. Butter likewise rubbed in with honey will be of service.
The flesh of an old pickle will relieve pruritus of the gums.
X. — On Aphtha.
Infants are liable to an ulcer of the mouth called aphtha. It is
either whitish, reddish, or black, like an eschar. That which is
BOOK FIRST. II
black is of the worst kind and threatens death. The iris mixed
with honey is of use, or you may blow in the dry powder if you
please : also, the pounded leaves of roses* or the flowers of roses,
and crocus — ^a smtdl quantity of myrrh, g^s, frankincense, or the
bark of the frankincense tree, all these together, or separately, may
be mixed with honey; and, in addition to these, may be joined
honied water, and the juice of the sweet pomegranate.
XI. — On Esccortations of the Thighs,
Excoriations of the thighs may be sprinkled with dried myrtle,
cyperus, and roses.
XII. — On Watery Dischargee from the Ears.
Watbrt discharges frcHn the ears may be dried up by applying
to them wool with alum, or with wine and honey, or by an injection
of old wine either alone or mixed with saflron.
XIII. — On Siriasis,
SiRiAsis is an inflammation oi the parts about the brain and its
membranes. A hollowness of the open of the head and eyes attend
it, with paleness and dryness of the body. It is relieved by an
application of the red of an egg with oil of roaes to the open of the
head in the form of a compress, and frequently changed.
. Another appHaUion for Siriasis. — Place upon the open of the
head, the leaves of that species of heliotropium called scorpiums,
the parings of a gourd, the memlnrane which envelopes the fleshy
part of a pompicm, the juice of the garden night-shade, with oil of
roses.
XIV. — 7%c Regimen of Infancy^ and the succeeding ages
until manhood.
Infants and children when weaned from milk, are to be allowed
to live marily and without restraint ; their food ought to be light,
aad their exercise gentle. After six or seven years of age, both
boys and girls are to be consigned over to writing-masters of a
mild and benevolent disposition ; as such persons will impart in-
struction to them in a cheerful manner, and without constraint ; for,
relaxation of the mind contributes much to the growth of the body.
Boys of ten years of age must go to teachers of grammar and geo-
metry, and harden their bodies by gymnastic exercises. From
fourteen to twenty- one, their proper employment will be the study
of mathematics and instruction in philosophy. At the same time.
12 TAULUS ^GINETA.
however, it will be proper to use more exercise for strengthening the
body, so that being accustomed to labour, both with mind and body,
they may be prevented from indulging their carnal desires. They
ought likewise to be restricted as to wine. To those who are in man-
hood's prime, the fullest supply of nurture, both to body and mind,
ought to be allowed ; wherefore, they should use all kinds of gym-
nastic exercises, particularly such as each has been accustomed to,
and food which is fitting and nutritious. In the decline of life, both
the bodily and mental supply ought to be abridged ; and the gym-
nastic exercises diminished in proportion. The food also is to be
gradually lessened as the habit begins to contract the frigidity of
age.
XV. — On the Preparatory Friction.
Before gymnastic exercises, the body ought to be rubbed mo-
derately first with towels, and then with oil in the hollows of the
naked hands, tmtil the body be properly warmed and softened. Its
surface ought to have contracted a florid blush, and its vessels to
be distended.
XVI. — On Exercises.
Exercise is a violent motion. The limit to its violence should
be a hurried respiration. Ehcercise renders the organs of the body
less liable to sustain injury, and fitter for their functional actions.
It makes the absorption of food stronger, and expedites its assimi-
lation ; for it improves nutrition by increasing heat. It also clears
the pores of the skin, and evacuates superfluities by the increased
motion of the lungs. Since, therefore, it contributes to distribu-
tion, care ought to be taken, that neither the stomach nor bowels
be loaded with crude and indigestible food or liquids ; for there is
a danger lest they should be carried to all parts of the body before
they are properly digested. It is clear then that exercise ought to
be taken before eating. The colour of the urine will point out the
proper time for exercise. When it is watery, it indicates that the
chyme absorbed from the stomach is still undigested. When it is
of a dark yellow colour, and bilious, it shows that digestion had
been long ago accomplished. When it is moderately pale, it indi-
cates that digestion has just taken place, and this is the proper time
for exercise, after having evacuated whatever excrementitious mat-
ters are collected in the bladder and bowels.
XVII. — On the kinds of Ea^ercise.
This is the common effect of all kinds of exercise, that they increase
the natural heat of animals ; but each species has something peculiar
to it. Strong, that is to say, violent exercise rouses the tone of the
muscles and nerves. Such are digging, and lifting a heavy bur-
BOOK FIRST. 13 ^
•
den, while one remains in the same spot, or moves a little ; or lift-
ing small weights and walking ahout as much as one can. Of this
kind, is the exercise of scaling a rope, and many such. The swift
kinds of exercise are such as do not require strength and violence,
namely — running, fighting with one's shadow, wrestling with the
extremities of the hands, the exercise with a leather-hag, and that
with the small hall. This last is compounded of strength and ve-
locity ; and such exercises as are strong, may become intense by add-
ing velocity to them. Besides, some kinds of exercise bring the
loins into action, and some the hands or legs ; others the spine or
the chest alone, or the lungs. And exercise ought to be carried on
until the vessels become distended, and the skin of a fiorid hue ; and,
until then, the motions ought to be strong, equable, and unremit-
ting. Upon this you may see warm sweat, mixed with vapour,
break out. It will then be time for you to stop, when any of the symp-
toms which I have mentioned have undergone a change, namely,
when the bulk of the body becomes contracted, or when the florid
colour of the skin declines. And, should any of the motions remit,
it will then be time to stop ; or, if there should be any change in
the quantity or quality of the perspiration ; for, if it should become
smaller in quantity, or colder, we must desist, and besmearing the
body with oil, endeavour to restore it. It will then be proper to
use the Restorative friction as the masters of gymnastics practise.
XVIII. — On the kinds of Friction.
Hard friction contracts, and soft relaxes ; so that those parts of
the body which are relaxed should be rubbed hard, and those which
are contracted softly. When the body is neither in the one state
nor the other, it is clear that neither the one mode of friction nor
the other should be had recourse to, but as much as possible either
extreme ought to be avoided. Much and hard friction diminishes
the bulk of the body, whilst, on the other hand, little and soft distends
it. If the three different kinds of frictions as to quantity be joined
to the same number as to quality, they will produce nine combina-
tions, as is stated below. For one of the kinds, as to quantity, for
example, much, being complicated with the three differences as to
quality, I mean the hard, the soft and the moderate as to hardness,
will produce three combinations ; and, again, the little being joined
to the other three, will produce three more ; and the moderate as to
quality being complicated with the same three, will produce more,
as is shown below : —
QUANTITY. QUALITY.
llittie^^^.^^-.^^^^-^^^w f "I >^^ r- ^HOrd.
Little,«s^s«««,«s^s.rs^^^>,..s,< and >,«s...>«vr<«vrwrv^,^><^^>^Soft.
Moderate -^^^v^^r^-r.-. r "I -rv^s^^^^^-v^v^^^N^Hard.
Moderate .^^^^.*s^s^< and \.r.r.^.r.^ ^..^^Soft.
Moderate ^^v^,^-rwr^ L J ^^^^^.^.r^^^ -^Moderate.
14 PAULUS iEGINETA.
XIX. — On Vociferation, or the Exercise of the Voice,
I^ the exercise of the voice, regular and gentle modulation con-
tributes nothing to health, but the utterance of louder tones is be-
neficial, and is therefore to be practised. For much air being
inhaled by respiration expands the chest and stomach, and dilates
and extends all the pores of the body. Wherefore, even in reading,
it promotes the excretion of redundiant humours, to those who read
in a high tone, by inducing sweats ; while in those who read with
a moderate tone it promotes the insensible perspiration over the whole
frame. It also promotes health by attenuating the excrementitious
matters which are hawked up ; the saliva, mucus, and phlegm being
discharged and consumed in this way. And to those who stand in
need of warming, owing to frigidity, what mode of relief can be more
proper than the action of respiration } Such persons ought therefore
to read frequently, and relaxing the whole body, so as to distend the
wind-pipe, and all the other passages of air, endeavour to utter the
loudest soimds. And yet we must not have recourse to the exercise
of the voice rashly, and without consideration, nor when the system
is filled with depraved humours, or the stomach loaded with crudi-
ties, lest noxious vapours be thereby distributed over the whole body.
XX. — On Lassitude from Exercises,
That species of lassitude called the Ulcerose is occasioned by a
collection of thin and pungent superfiuities in the body. In the Ten-
sive there is scarcely any superfluity in the system, but the state of
the muscles and nerves is such that they appear to be stretched. The
Inflammative, in which we feel as if the parts of the body were
bruised or inflamed, happens when, being heated, the muscles at-
tract the surrounding superfluities. There is a fourth species oc-
casioned by an unnatural dryness of the muscles, in which the body
when naked appears squalid and constricted, and is averse to motion.
The cure of the ulcerose species consists in dispelling the superfluities
by much and soft friction with plenty of oil that contains no astringen-
cy. The indication of cure in the second or Tensive species is relaxa«
tion, which may be accomplished by means of little and soft friction
with oil heated in the sun ; by quietude and rest, by tepid baths, and
remaining for c( considerable time in the warm water ; for, if you
repeat the bath two or three times in succession, you will confer so
much the greater benefit. In the third species, or the Inflammative,
there are three indications of cure, the discharge of the superfluity,
the relaxation of the constricted parts, and the cooling of the inflam-
matory state. Plenty of tepid oil, the softest friction, and remain-
ing long in a bath of a moderate temperature, remove lassitudes of
this description. Long continued quietude is also proper, and re-
peated inunction. The treatment of the fourth diflfersin no respect,
for the first day, from that of the third, except that the water ought
BOOK FIRST. 13
to be hotter, so as to contract gently. On the second, the Restora-
tive kind of exercise must be had recourse to; and when in the bath,
let the person straightway leap into the cisterns of cold water. All
those affected with lassitude stand in need of wholesome food.
XXI. — On Constriction of the Skin.
Constriction is occasioned either by obstruction or contraction
of the pores. Obstruction is produced either by the quantity or
thickness of crude and indigested humours, and contraction either by
cold, astringent, or desiccative substances. Upon stripping the body
the affection is at once recognized, by the paleness, hardness, and
contraction of the skin, and by the body's being heated with diffi-
culty during exercise. Cale£Eu;ient remedies are the proper cure for
this state of body, and therefore we must have recourse to the
strongest exercise and the hottest baths, and the time of remaining
in the cold bath must not be long, nor must the water be very cold.
And when about to put on their clothes, let their bodies be anointed
with a sweet and thin oil, of a moderately heating quality. Ob-
structions of the skin are also properly cured by the oil of dill,
(more particularly if the dill had been green,) and by the oil of black
poplars.
XXII. — On SponianeotAS Lassitude.
SiNCB the ulcerose lassitude is occasioned by the ill digestion of
acrid superfluities, if the cacochymy be small, the restorative exer-
cise will be sufficient ; but if it be greater and deeper-seated, we
must not permit such a one either to exercise or to take any motion
whatever, but he must for one day remain without food, in a state
of quietude and sleep ; and then in the evening, when he has been
rubbed with emollient unguents, and bathed in tepid water, we must
give him wholesome food and some soup. And we must also not
restrict him from wine; for nothing contributes so much to the di-
gestion of half-digested humours as wine. Should the symptoms
be removed by means of the aforesaid treatment, we may allow the
man to return to his usual employments ; but if on the following
day they should still remain, we must bethinjc ourselves of a more
potent remedy. If his strength be good, we must have recourse
either to phlebotomy or purging, having first determined which of
these remedies we shall try. If he be weak, we must not bleed,
but may purge him moderately. If there be many crude humours
in the system, we must neither bleed, nor purge, nor exercise, nor
move at all, nor tiy the bath, but we must keep him in a state of per-
fect quietude, and give him food, drink, and medicines of attenuating
and incisive qualities, without being of a manifestly heating nature.
We may give him vinegar and honey, and occasionally some ptisan
or honied water. And since, in such persons, the hypochondrium is
16 PAULUS ^GIXETA.
apt to become swelled and distended with wind, and whatever food
is taken to be converted into flatulence, it will be better to give
some pepper along with the food. It will be better too to use the
composition called Diospoliticus, and that Simple Medicine which
consists of three kinds of peppers. Oxymel is also most pro-
per. We may likewise use a drink made from honey, particu-
larly when it begins to become acid ; and such wines as are gently
acid, and such articles of food as are attenuant without being heat-
ing, as capers, if taken with vinegar and honey, or vinegar and oil.
When the tensive species of lassitude takes place without exercise,
it indicates that a plethora distends the solid parts of the body.
If the fulness be occasioned by blood, it will be best to open a vein,
or scarify the ancles. If the inflammative lassitude be spontaneous,
it will not endure a delay of a few hours, much less of two or three
days, for it straightway induces a strong fever, unless one anticipate
by letting blood. It will be best, if possible, to abstract blood
twice in one day ; for if care be taken that the first bleeding do
not occasion swooning, it will be of less consequence whether or not
it occur after the next. Those who are not bled will be fortunate
indeed if they escape with the life.
XXIII. — On the Regimen of Old Persons,
Old age is dry and cold ; and its correctives are calefacients and
diluents compounded with them. Friction is to be applied to the aged,
but so as not to occasion lassitude. To such as are weak, some such
course of diet as the following is to be prescribed : — About the third
hour, a small bit of bread with Attic honey; and afterwards, about the
seventh hour, after having undergone friction, and taken exercise and
baths suitable to old men, they must first get such things as are of a
laxative nature, and afterwardsfish or fowls; and then for supper, such
things as are wholesome, and not apt to spoil in the stomach. I also
do not forbid them to use wines prepared with honey, particularly such
persons as are suspected of being threatened with the stone or gout,
and in that case, a little parsley may be added. If phlegm be gen-
dered in the stomach, we must of necessity apply such remedies as
will remove it, and return immediately to a diluent diet : We must
give them ripe figs in preference to every other kind of food, and if
during the winter, dried figs, unless they complain of unpleasant
sjonptoms in the right hypochondrium. When serous and pituitous
recrements collect in the bodies of old men, we must promote the
discharge of urine every day, and soften the belly, principally by giv-
ing oil before a diet. It is obvious, that all pot herbs ought to be
eaten before all other food, with oil, pickles, or olives and dama-
scenes seasoned with salt. When the belly is bound, the herb
mercury, and the bastard saflPron, will relieve it. Turpentine also is
proper in such cases. It may be given sometimes to the bulk of a
Pontic walnut, and sometimes of two or three. Oil also in a clyster
is most useful to those who are constipated.
BOOK FIRST. 17
XXIV.— For Rugosity of the Body.
RaaosiTT of the body may be removed, by the farina of bitter
tares, mixed with white vine.
Another abstergent composition (smegma), to be constantly rab-
bed upon the skin : — ^Fat figs braised with bryony, and the burned
powder of tares, the shells of the cuttle-fish (sepia), mixed with a
small quantity of honey.
XXV. — To make the Perspiration fragrant^
Thb perspiration may be rendered fragrant, by mixing the leaves
of the cypress, pounded dry, and the bu-k of the pine in the same
ointment. One ought also to remember in the morning, immedi-
ately after being db-essed, to taste a small quantity of cassia or
savin.
XXVI.— Tb warm the Haint.
SiNCB even the habit must be warmed, it will be proper to use a
preparation of a heating nature when in the bath. Let it contain
calamint, maijoram (sampsuchum), hyssop, bay berries, rosemary,
the stone p3rrites, salts, the burnt lees of wine, nitre, pumice stone,
each in proper proportion ; also, a smaU quantity of mustard, staves-
acre, and the seeds of the thymekea (granum cnidium). After the
bath, use a warm restorative (Acopmn), and drink a yellow old wine,
having previously taken a draught ftom wine and honey, pepper,
me, and the like.
XXVIL— For Paleness.
Palbnbss of the body is diminished by a merry course of life,
and grateftd food, by mixing together radishes, leeks, and the green
chick-pea. Taking the juice of the sweet pomegranate restores
the complexion. (Ml, in which the root of the white vine (bryonia),
has been long boiled, is likewise proper. This gives tone to the
body. For detergent applications, mix some agghitinants with
detergents, as farina, the bulb of the narcissus, and the root of the
bryony. The root also of the bitter almond, if taken in abundance
wUl improve the colour, and likewise the fruit boiled in water
Qsod for a bath.
XXVIIL— 0» Uvidity.
Livid spots are prevented from forming on old men, by render-
ing, their skin thick and hardy, and by warming the habit. In
0
18 PAULUS ^QINETA.
order to dispel them, the black places should be rubbed in the bath
with salts, and fomented with sponges steeped in a decoction of rad-
ish or wormwood.
XXlX.-^Preservatives of the Teeth.
Thb teeth will not decay if the following things be attended to :
In the first place, to avoid indigestion, and frequent repetitions of
emetics. Guard against such food as is hurtful to the teeth, as
dried figs, honey boiled, so as to become very hard, dates which
are difficult to rub down, and all glutinous substances ; likewise
such things as are difficult to break, and may thereby loosen the
teeth ; in like manner also, such substances as set the teeth on edge,
and every thing ^which is cold and putrid. The teeth also ought to
be cleaned after supper.
XXX. — For dulness of Hearing.
DuLNESS of hearing may be prevented by clearing away the sordes
from the meatus, and by occasionally introducing into the ear
a piece of linen dipped in a calefacient ointment (dropax), pressing
it down, and then drawing it out ; for this completely clears the
opening, and, at the same time, stimulates the sense of hearing.
Afterwards, the meatus is to be plugged up with a piece of wool of
the size of a tare for a day ; and, when it is taken out, the meatus
is to be anointed with the oil of almonds, of spikenard, or of chamo-
mile, with the fat of geese, or a small quantity of ox gall. Again,
after a time, rubbing mustard and figs together, introduce this col-
lyrium for two hours ; and, when it is taken out, pour in oil heated
in the hollow of the root of the asphodel.
XXXI. — On dimness of Sight.
In order to avoid dimness of sight, when they plunge into cold
water people ought to open their eyes wide, for thereby the strength
of their eyes will be much improved. They ought also tp be care-
ful not to hurt them by reading. Let them also avoid wine that is
thick and sweet, such articles of food as ascend upwards, whatever
is of difficult digestion, and engenders stagnant and thick humours,
the herb rocket, leeks, and every thing whose pungency ascends to
the head. Let them also avoid reclining long in a supine position,
cold, winds blowing direct in the face, smoke, and dust ; and pour
daily into the eyes an infusion prepared thus : For a month and a
day, put green fennels into an earthen vessel smeared with pitch on
the outside, and pour in rain water, and then taking out the fen-
nels, keep the water laid up for use.
BOOK FIRST. 19
XXXII. — On Repkiian.
£xcx88 in diet is a very great error ; for, even if the stomach
^uld digest it properly, ^e veins, being too much filled, labour,
are distended, burst, become obstructed, or are swelled up with
vapours, and become much oppressed. In diseases, nothing is
worse than plethora of the veins ; for, in plethora of the stomach,
the offisnding matters may be evacuated either upwards or down-
wards, so that it is less pernicious than the other, and yet it is by
no means desirable ; but, if there be too much food in the stomach,
it must be immediately evacuated by vomiting, for there is a danger
lest being digested it fill up the veins, more particularly if the per-
son who is g^ty of the excess be not attentive to the necessary eva-
caations. Let him vomit, then, before the food become corrupted ;
or, if there be any objection to vomiting, it will be of great conse-
quence to bring about frequent discharges ftrom the belly ; or other-
wise, he should indulge much in sleep, and drink often of tepid
water. When he has digested properly, and more especially if he
has had evacuations by ti^e bowels, let him have baths and fomen-
tations, and let him drink moderately of watery draughts, and eat
Bome pickle. But should )ie neither have alvine evacuations, nor
digest readily, and if his whole body be heavy, averse to motion,
and sleepy, and if his mind be oppressed with unusual sluggishness,
these sjrmptoms indicate plethora of the veins ; and, when lassitude
snp^venes to these, it will be proper to enjoin quietude until diges-
tion in the stomach be accomplished, and then evacuate by labour.
XXXIII. — On Initmcatwn.
To those who are intoxicated, vomiting is an immediate relief.
It will be proper that they drink freely of water and honied water,
so that they may vomit freely, and remove the uneasy feelings.
After vomiting, let them use the bath, along with plenteous unc-
tion, and afterwards rest for some time, well covered up, until they
have slept off their debauch.
XXXIV — On wronff digestion of the Food.
It contributes much to the health of those whose food spoils in
tlieir stomachs, that the ofiending matters be discharged down-
wards ; and when they are not so discharged naturally, this opera-
tion ought to be promoted by gentle laxatives. Such persons be-
fore a meal may, with advantage, take an emetic of wine, or
must. They ought also to be counseUed not to take food of a
itrong or offensive smell, nor such as easily becomes spoiled ; but, on
tiie contrary, such as is wholesome. To such persons, evacuations of
tile bowels at proper intervals, by means of gentle laxatives, are
lagkly expedient.
c2
20 PAULUS iEGINETA.
XXXV.— O/i Venery.
From sexual enjoyments, the following advantages may be de-
rived : they relieve plethora, render the body lighter, promote its
growth, and make it more masculine ; they free the mind from the
cares which beset it, and dispel ungovernable anger. Wherefore,
the best possible remedy for melancholy is coition. Those also who
are otherwise affected with mania it will restore to reason. It is also
a powerful remedy for phlegmatic disorders, will restore the appe-
tite to those who want it, and dispel continued libidinous dreams.
The habits which are most adapted for venery are the hot and hu-
mid, and these bear it best. A dry and cooling diet, old age, and
the season of autumn unfit for it. The diet, therefore, ought to be
humid and heating ; and moderation as to labour and food ought to
be observed. And as other kinds of labour are of use, so also are the
venereal, when taken in moderation ; for they incite to the act, and by
habit, induce facility of performing it. But nothing is so much required
as abundance of food, which also ought to be of a nutritious nature.
Of fishes, the best are polypi, (which are otherwise supposed to in*
cite,) and all the class called mollusca ; of pot-herbs, the all-good
(horminum), hedge-mustard (erysiraumX, rocket (irio), and turnip.
And the following are similar medicines : — of pulse, beans, chick-
peas, tares, gallic beans and pease, which fill the body with vapours
and abundance of food. Rue, as it concocts and dispels flatulence^
blunts the venereal appetite. * But I greatly approve of grapes,
which supply the body with moisture, and fill the blood with flatus,
which rouses to venery. He who is about to proceed to the act
ought to avoid repletion, indigestion, lassitude, precursory. vomits
and purges, and, in like manner, a sudden diarrhoea ; for a chronic
one is sometimes cured by venery. And strong desires I do not ap-
prove of, but think that they ought to be contended against> especi-
ally by those who have any distemper. The most proper season for
enjoyment is after gymnastic exercises, baths, and a moderate re-
past ; for food contributes to the strength, and diminishes the chills
which succeed it. The most proper time, as I said before, is after
eating, and before sleep, for the lassitude is relieved by sleep. This
too is the fittest time for procreation on many accounts, and because
that the woman falling asleep is the more likely to retain the semen.
XXXVI. — On Impotence.
In cases of impotence, it may be proper to rub the parts frequently
with an ointment containing a small part of the root of the narcis-
sus, or the seed of the thymelaea, or pellitory, or stavesacre, or the
seed of the nettle, or of anise. Let him also beforehand take a drink
with pepper, or satyrium, or rocket, or bastard saflron, or all together.
Before food, let him also eat the small red bulbi roasted, with salt
and oil, or a little of the squill dried in the sun. He may also use
BOOK F1A8T« 21.
the compound preparations elsewhere described, and often indulge
in obscene reading.
XXXVII. — On inordinate Venery,
Since by too much indulgence the body becomes flabby, cold,
dried, and weak, it must be supplied with such things as will
brace, warm, humectate, and strengthen it. To those who in-
dulge themselves immoderately, warm clothing is suitable, also rest
and sufficient sleep until the body remits from its contraction, and
they recover from their atony.
XXXVIII. — On redundance of Semen.
SoMB persons collect much semen of a warm nature, and then
proceeding to coition and discharging it, render the body weak,
occasion resolution of the stomach, and so become emaciated and
dry : or» if they abstain from venery, they are seized with heaviness
of the head and anxiety ; after which, they have libidinous dreams,
and the same thing tsikes place. They must therefore avoid those
things which engender semen, and take such kinds of food and
medicines as consume it. After the bath, they ought to have their
loins rubbed with the oil of roses, or that of apples, or of unripe
dives ; and it is better to make them thick by mixing a little wax
with them, and the juice of some cooling herb, such as the house-
leek, solaniim, the umbilicus veneris, or flea-wort. In summer,
these may be used, but at other seasons, salt, and the juice of the let-
tuce and linseed boiled in water, for it also furnishes a cooling chyme.
And a plate of lead applied to the loins will prevent libidinous
dreams^ and herbs of a cooling nature, as rue and the tender
tops of the chaste-tree, if strewed under one in bed, will have the
tome effect. For this purpose, also, the seed of the chaste-tree and
of rue may be eaten* Care, however, must be taken that the loins
be not too mudi cooled, lest the kidneys be hurt.
XXXrX. — On concealed Persons.
Those who are much congealed ought to be laid in a warm place,
and rubbed with the oil of privet or of the iris. Afterwards,
when moderately heated, they should get pepper, or myrrh, with
sweet fragrant old wine, or cyrenaic juice in wine or vinegar, or
pelhtory or castor with vinegar, and take food of a warming nature.
XL.^—For Pe7*sons scorched by the Sun,
A PBRSON who has been scorched by the sun should be laid in an
airy place, and have his face, hands, and legs bathed with cold wa-
22 PAULUS ifiGINETA.
ter. If thirsty, he may drink cold water, if in the practice so to do ;
this, however, oaght to he done considerately, and not much at a
time. Let him also take some food of easy distribution, rather of a
humid than of a solid nature.
XLI. — On Collections of Phlegm in the Stomach.
If you should meet with a person who loaths any wholesome
food which is offered him, who abstains from food, or, if compelled
to take it, becomes sick, who longs after only such things as are
acrid, and has no pleasure even in them, but has his belly swelled
up with flatulence in consequence, is seized with nausea, and enjoys
only a short respite by eructations, and on whose stomach every thing
spoils and becomes acid, — ^know for certain that the remedies which
will afford him relief are such as will clear the stomach of phlegm.
I have known one of those so affected, after taking an emetic, con-
sisting of radishes out of ox3rmel, bring up an incr^ble quantity of
very thick phlegm, by which he has been straightway restored to
heaJth.
XLII. — How to produce easy Vomiting.
SiNCB to those who vomit with difficulty many disagreeable con-
sequences are apt to happen, it will be proper to explain by what
methods one may be made to vomit roidily. For this operation
evacuates phlegm and lightens the head, and prevents one from
being injured, although one had taken immoderately of indigestible
food and wine. Let the substances which are taken be neither sour
nor dry, but part of a sweetish and liquid nature, and part acrid.
Among these the radish is deserving of praise, and also the rocket,
and old pickle, green marjoram, and a small quantity of onion and
leek. Vomiting is likewise promoted by ptisans of poise, containing
some honey ; by porridge of bruised beans, and the lat of flesh ; but
one must not only take the juice, but swallow whole lumps of it.
And one must not spend much time upon mastication; but they ought
to be soft from boiling. It is clear, also, that it is the sweetish
kinds of wine which ought to be preferred, for such are aptest to
swim upon the stomach ; and tepid drink ought to be used. It is
necessary also to eat almonds dipped in honey, also sweet cakes,
and the moistened seed of the pompion and cucumber pounded with
honey. The root likewise of the cucumber rubbed with honey has
some effect. Those who wish to use more powerful medicines, mix
some wine with a decoction of the bulb of the narcissus. Vomiting
is also produced by the ointment of iris, if one will smear one's
fingers in it and tickle one's throat. It is also to be attended to in
vomiting not to intermit after vomiting is once begun, and to bathe
the face, and wash the mouth with sour wine or water, for this is
beneficial to the teeth, and relieves the head.
BOOK riasT.
XLIII. — On Laxaikfei and Diuretics to those in Health.
SoMB of the ancients thought it sufficient for health that the
bowels and urine should be evacuated once a-day freely and fully,
according to the quantity of food and drink which had been taken ;
and, -when the eracuations were agreeable to this rule, they were
satisfied, or, if otherwise, they endeavoured to correct them by
taking, in order to increase the urinary discharge, shepherd's needle,
parsley, asparagus, Macedonian parsley, anise, calamint, marjoram,
wormwood, the roots of grass and of golden thistle, tree-medic,
maiden-hair ; all these being boiled in water, so that the decoction
might be drunk with wine. For these things purify the blood by the
mine, and are of no small consequence. Alvine discharges they pro-
moted by giving turpentine to the quantity of an olive, when going to
rest, or, when they wished to purge more effectually, by adding a lit-
tie rhubarb. Soft eggs, of pot-herbs the beet and mallows, and the
wrap of shell-fish, are also laxative, and these probably will be suf-
ficient-; but, if more powerful remedies be required, the herb mer-
cury boiled in water with salt may be eaten, or the decoction drunk ;
and, in like manner, the leaves of the elder tree (sambuchus), or
the root of the oak-fern (polypodium), to the amount of two drams,
may be sprinkled upon pickle, or swallowed in a ptisan ; or milk-
whey, with salt ; or honey, to the amount of three or four hsemi*
nte ; or the btoth ol an old cock, by itself or with two drams of
bastard saffiK>B, or aloes, to the amount of about three chick-
peas, may be tkktn att supper-time. But the best remedy is dod-
def of thyme,- taken in wine after a moderate supper; but he
that wislM to puTj^ more strongly must take, in the morning, a
dram of this me^Mne infused in vinegar and honey, in the spring
season.
XLIV.— On Clysters.
In constipation of the bowels, when the stomach is so weak as not
to bear purgatives, we must have recourse to clysters. When phlegm
is contained in the intestines, the clyster may be composed of the
decoctions of dried figs, and of beet, nitre, the root of the wild
cucumber, honey, and the oil of chamomile or dill. But when the
complaint proceeds from dryness, they may be composed of those of
marsh-mallows, fenugreek, chamomile, oil, and a small quantity of
honey. And sometimes oil alone, injected to the amount of half a
hsemina, will produce the desired effect ; but even this must not be
repeated constantly, lest nature, by becoming accustomed to these
things, should forget to perform the evacuation spontaneously.
XLV. — On Suppositories.
Wb often use suppositories for the discharge of scybalse, or when
injections are not properly evacuated. Suppositories are formed of
24 PAULU8 iEGXNETA.
roasted salt, honey, and nitre ; or thyme may be mixed with boiled
honey. They are also formed of turpentine rosin, and nitre, and
sometimes with a moderate quantity of the seeds of the thymelsea
(granum cnidium). But it irritates the parts, which, therefore,
ought to be rubbed with oil. Pellitory and pepper are also added,
and are particularly fitted for paralytics, and for the relief of flatu-
lence from cold. Centaury also is mixed with pitch and cerate,
and is very applicable for paralysis of the genital organs* For in-
fants, a bit of thick salt is applied. Figs also are mixed up with
nitre.
XLVI. — On Medicines which evacuate Phlegm from the Heady
Maaticatories, Errhines and lAniments to the Nose.
Wb evacuate humows in the head with the saliva, by mixing a lit-
tle pepper with mastich, if a small discharge only be required ; or, if a
greater evacuation be wanted, by directing to chew pellitory or staves-
fskre. The root of every species of anemone, when chewed, also excites
the secretion of saliva, and the bark of the root of cappers. Serous
superfluities may be thus evacuated ; but, for thicker phlegm, we
must gargle with mustard in vinegar and honey, or with sodden
wine, having maijoram and hyssop boiled in it. I also mix this
with the gargle formed of mustard in vinegar and honey. When
we want to clear the brain of mucus, we must stimulate it by means
of acrid substances, of which kind some are sternutatories, llie juice
of either pimpernel, of the anemones, and of beet, purge by the nose.
The juice also of the leaves of the wild cucumber may be applied to the
nostrils, either alone or with the decoction or juice of the beet. But
sneezing is not at all applicable for crude humours contained in the
chest, lungs, and head. The following ointment may be rubbed
into the mouth : Anoint the roof of the mouth and uvula with a
soap containing the juice of the beet. The same application may
be used as an errhine. I have also often used the following com-
position, which is easily prepared : Macerate gith in strong vinegar
for a day, then next day rub it with the vinegar, and pour it into
the nose. Sometimes the gith may be rubbed with old oil ; and I
apply it in this manner. Archigenes used it in the same manner
for obstruction of tiie nostrils. Crito used the former cure, along
with vinegar, for jaundice.
XLVII. — On Emmenagogu^s.
All diuretics promote also the flow of the menses, such as the
decoction of the root of the cabbage, the root of the peach, rue,
marygold, dittany, and the seed of rocket. The same effect may be
produced by certain substances when applied to the mouth of the
womb, such as rue rubbed with honey, or the juice of leeks, or
finely-powdered germander (trisago), or myrrh, pounded in wine,
or the rennet of a hare.
BOOK FIB8T. 25
XLVIII.— On Sudorijics.
The following medicines are sudorifics: The dried powder of
chamomile, mixed with oil and rubbed upon the skin, seseli, pel-
litory, the seed of the rosemary ; anise, idso, when sprinkled upon
oil ; nitre toasted, and not very fine, with oil ; the flower of salt
mixed with oil ; cyrenaic juice dilated with water, which may be
nibbed into the body, and taken in a draught, to the amount of a
chick-pea. Calamint, in like manner, may be drank with honied
water, and rubbed externally with oil.
XLIX.— On Airs.
Thb best kind of air is that which is perfectly pure, such as that
which is not defiled with the exhalation from lakes or marshes, nor
from any pit which emits pestilential vapours. That also which is
impregiuited with the exhalations from a canal conveying the impa-
rities of a city is deleterious, and indeed every kind whidi is loaded
with vapours is not good ; as also that which is contained within
any hollow place shut up on all sides by high mountains, and not
admitting of ventilation. Those, therefore, which are thus deleteri-
ous, prove hurtful to all ages and temperaments, whereas the best
kinds agree with all ; but their difierences as to quality, I mean heat,
cold, dryness, and moisture, have not the same cdSect upon all.
Those of a proper temperament are benefited by temperate air,
whereas those lid>ouring under an intemperament derive benefit from
the opposite one.
L. — On Waters.
It is necessary also to be skilled in the good and bad proper-
ties of waters, for of all things water is of most use in every
mode of regimen. It is necessary to know that the best water
is devoid of quality as regards taste and smell, is most pleasant to
drink, and pure to the sight ; and when it passes through the prse-
cordia quickly, one cannot find a better drink. But such as remains
long there, and proves pungent to the stomach, which it swells up
with wind, and oppresses, is to be reckoned pernicious. Such wa-
ters are neither soon heated nor cooled, and tiiose things which are
boiled in them are slowly and improperly boiled. It is better there-
fore to prove such water by trial, which he who wishes may do by
attending to the following characters : — ^Those which run to thp
north and from the sun pass slowly through the stomach, and are
indigestible ; they are slowly heated and cooled. Those which arc
strained through any passage or soil to the east are soon cooled
and soon heated, and are to be supposed to be very good. Those
also are good which are colder in summer and warmer in winter.
26 PAULUS ifiOINSTA.
Some judge of waters by weight, counting that the best which
is lightest. This, if joined to the circumstances already mention-
ed, may be deserving of consideration, but is not of itself a suffi-
cient criterion of goodness. Rain water, as Hippocrates remarks,
is the lightest, the sweetest, the most limpid, and the thin-
nest, because that which is lightest and thinnest is attracted by the
snn, who draws snch particles to him, not only from all other wa-
ters, but also from the sea, and from bodies. Hence also it is the
most prone to putrefaction, as being composed of many different
qualities. Let no one suppose that the water which is most prone
to putrefaction is the worst, for susceptibility of change is rather a
good than a bad property ; so that if it has the other characteristics
of good water, and is prone to putrefaction, it is to be reckoned the
best possible. When beginning to turn it proves the cause of
hoarseness, coughs, and difficulty of speech, to those who drink it.
Of rain waters, that which falls in summer, and during thunder, is
preferable to that which fedls in stormy weather. That from ice and
snow is the worst, for during coagulation the finest particles of the
water are squeezed out. But waters which contain impurities, have
a fetid smell, or any bad quality, may be so improved by boiling as
to be fit to be drunk ; or, by mixing them with wine, adding the
astringent to that which is sweeter, and the other to the astringent.
Some kinds of water it may be expedient to strain, such as the
marshy, saltish, and bituminous. Those which are very cold are to
be drunk after food, and not in great quantity. Some also have
discovered certain articles of food and drink for correcting the bad
properties of waters. Hius, some beforehand drink of the decoction
of chick-peas, or eat them ; others, wild carrots boiled with some
small fish, and fennel in like manner ; whilst others again eat beet
and gourds beforehand with salt and diluted wine.
LI.— On Baths.
s
I THINK well of the cold bath, and yet I do not say that it is
proper for those who use no restriction as to diet, but only to those
who live correctly, and take the necessary exercise and food. It
tnay answer with most people very well, when they want to get
much cooled, to swim in water during the season of summer,
provided they are young and brawny, and have been previously
heated by friction. They ought to attend, however, that they be
not in a state of lassitude from venery or any other cause, nor suf-
fering from indigestion, nor after vomiting, nor after evacuation of
the bowels, nor when in want of sleep. It may be attended with
danger, if used at random. But the warm bath is the safest and
best, relieving lassitude, dispelling plethora, warming, soothing,
softening, removing flatulence wherever it fixes, producing sleep,
and inducing fulness of the body. It is expedient for all, man and
woman, young and old, rich and poor.
BOOK PIB8T. 27
LIL— On the Natural Baths.
Of natural baths, some are nitrous, some saline, some alaminoos,
some sulphureous, some bituminous, some copperish, some chaly-
beate, and some compounded of these. Of natural waters in gene-
ral, the power is, upon the whole, desiccant and calefacient ; and
they are peculiarly fitted for those of a humid and cold habit. The
nitrous and saltish are beneficial to the head, to defluxions of the
chest, to a watery stomach, to dropsies, to swelling after diseases^
and to collections of phlegm. The aluminous are fitted for spitting
of blood, vomiting from the stomach, immoderate menstrual dis-
charges of women, and repeated miscarriages. The sulphureous are
sootMng and warming to the nenres, and relieve lassitude, but weaken
and upset the stomach. The bituminous occasion fulness of the
head, and hurt the senses^ bat occasion a steady degree of heat and
soothe when persevered in« The oopperish ai« peculiarly adapted
for the mouth, tonsils, uvula, and eyes. The chalybeate are useful
to the stomach and spleen. The deeeent into the watar ought to be
without precipitation, in order that its impression may sink deep
into the body when relaxed.
lAlI.'-^On the regimen fitting to the di^ereni Seaeone.
It will be proper to regulate the diet with a view to the season.
In winter, take more fatigue, and eat more than usual, if the state
of the weather be northerly ; but if it be southerly, take the same
fatigue, but use less food sjui drink. In fine, make the body dry in
the wet season, and warm in the cold. Eat also warm fleshes and
acrid pot-herbs, and drink more wine than usual. In the beginning
of spring, either evacuate by emetics, or by laxatives, or get a vein
opened, according as habit or inclination directs'. Rest is suitable
to the season of summer, and also a diminution of labour and food ;
the food also ought to be more cooling, and the drink abundant \
and, in short, every thing ought to be done which can contribute to
cooling and dilution. In autumn, as it is a changeable, unsettled,
and unhealthy season, the diet ought to be particiidarly attended to,
that it be not too refrigerant ; moderation as to venery and cdid
drink ought to be observed ; and the cold breezes of morning, and
the heat of noon attentively guarded against. Too much fruit ought
likewise not to be taken, being hurtful not only by the quantity, but
also by the quality of the chyle which it supplies, and by engen-
dering flatulence. Nay, even tibe best kinds of fruit, figs and grapes,
occasion wind, unless taken before any other food, iot otherwise
they spoil the other food ; but if taken then, they neither occasioii
wind, nor spoil the other articles of food. When the air is cold,
the body must be warmed accordingly, and every thing done as in
the commencement of winter. It may also be expedient, after the
autumnal solstice, to have recourse to one of the afore- mentioned
28 PAULUS iEGINETA.
evacuations, lest any excrement! tious particles being shut up in the
system, should prove hurtful during the winter.
LIV. — Of the regimen of Persons in Business.
Hb who spends his time in business ought to consider, whether,
in tiie former period of life, he had been in the habit of taking exercise,
or whether, while yet taking exercise, he bears that habit well, and
escapes from diseases by having free perspiration. Such a state of
body is not to be suddenly changed to another habit, neither the
mode of those who have long been in ill health. But if his com-
plaints be protracted, and proceed from plethora, the indication of cure
ought to be by a healthful regimen, to supply moderate nourish-
ment ; or, if cacochymy was the cause, the indication will be to sup-
ply proper juices. Those who suffer from fulness are to be directed
when they go into the bath to use friction, and to take some exer-
dse, or, if accustomed to do so, to increase it a little, but to detract
from their food, and use less nutritious kinds than formerly ; but if
from collections of bad humours, one indication of cure is not suf-
ficient, because there is more than one kind of bad humours ; for,
some have a collection of cold and pituitous, some of hot and bilious,
and others of the melancholic. Every one, therefore, ought to
avoid those articles of food and drink which are apt to engender
that sort of humour which is collected. And in all these cases the
common remedy is purging of the belly.
LV. — On the regimen of Travellers.
In performing a journey, one will bear the fatigue best if anointed
with oil, and by not making too great stretches, and having the body,
about the loins and to the hollow of the ribs, bound round, in sum«
mer, with a swath of a soft consistence, six or seven fingers broad,
and in length not less than five cubits. A staff also will be useful
for the journey ; for in going down a declivity, by putting it before
\X will support the body l&e a pole, and by leaning upon it in
fUBcending it will assist in raising the body. When a traveller
stops, he should get his body anointed, take some food adapted for
the summer, and a moderate quantity of drink. After dinner, he
ought to rest a while before proceeding. But if compelled to go
on, and oppressed with thirst, he may drink water having some
polenta sprinkled upon it, with a moderate quantity of salt. He
should be careful of heat and of the sun, and have his body covered,
80 as not to be exposed to the sui^ lest during the journey his limbs
become dry and stiff. With these precautions, he will be less liable
to lassitude and its accompanying evils. In winter, as it is cold, be-
fore setting out he ought to evacuate, get his body rubbed with oil,
take plenty of the winter articles of food, and a little drink. He
should also get not only his loins, but likewise his spine and cUest
BOOK FIRST. 29
properly bound round with a broader swath. When he re^ts, if th6
cold be great, it will be better that he neither anoint, nor take food
or drink, nor any other refreshment, if he means to remain there.
But after long journeys, or excessive fatigue of any kind, even
if a person do not complain of lassitude, it will be proper to treat
him like those who do, for thereby there will be less danger of any
bad consequences.
LVI. — Of the regimen of Persons at Sea.
With regard to the vomitings which occur to people at sea, it is
neither easy nor expedient to contend with those which happen first ;
for, upon the whole, they are generally beneficial. After vomiting,
one ought not to use much, nor ordinary food, but either lentils, dried
and boiled with a small quantity of penny-royal, or bread pounded in
a weak and fragrant wine. One ought also to use but little drinkt
and that containing a weak watery wine, or vinegar with honey.
The lentils ought to be first boiled, and then when they become soft,
to be triturated, and afterwards dried and put into an earthen vessel.
When severe vomiting lasts for a long time, one should resolutely
abstain from all kinds of food, and take only a little drink, which
ought to be vinegar and honey with water, containing thyme in-
fused in it, or penny-royal water with some fine polenta, or some
fragrant weak wine with fine polenta also. In order to overcome
the disagreeable stench on board ships, one may smell to quinces»
thyme, or penny-royal. One ought also to look as seldom as pos-
sible upon the sea, until one has been accustomed lo live in a ship.
One must likewise attend, that the water which is drunk be not
muddy, ill-smelled, or saltish.
ItVII. — For dimifdshinff Obesity.
When the body gets to an immoderate degree of obesity, it will
be necessary to melt it down and reduce it. It was mentioned
formerly, that the warm temperament renders the body lean, and
therefore it ought to be superinduced, if possible, upon that of fat
people, in order to reduce them to the proper state. You have
also learned that active exercise, an attenuant regimen, medicines of
the same class, and mental anxiety, bring on the dry tempera-
ment, and thereby render the body lean. What an attenuant diet
consists of is perfectly obvious ; but the more powerful medicines,
such as the seed of rue, particularly the wild, with its tops, the
round birth wort (aristolochia rotunda), the small centaury, gentian,
poley, and the stronger diuretic medicines, as Macedonian parsley ;
all such medicines, either alone, or together, evacuate the humours,
and reduce the body. The salts also from burned vipers and the
theriac attenuate the body. The body may also be reduced and
attenuated, by having an oil rubbed into it, containing the root of
30 PAULUS ^OINETA.
the wild cucttmber, marshmallowB, gentian, and the root of the all-
heal and birthwort, or the poley and centaury. One ought not to take
food immediately after the bath, but should first sleep for a little
time. And it ¥dll be of consequence, if the water of the bath pos-
sess diaphoretic properties, and» more particularly, if we can have
recourse to a natural one, such as that in Mitylene. If it cannot
be procured, the flower of salt may be mixed with sea- water. Thin
white wines ought to be used. Dry rubbing with thick towels is
calculated to reduce the iiit. A small quantity of food ought to be
given in proportion to the exercise taken. Insolation also is of use
for obesity. Fat persons ought not to take a fragrant draught before
a meal ; and it will be best if they eat only once in the day. The body
ought to be rubbed with nitre (soda), and the rougher salts. A large
quantity of nitre in the bath is attenuant, but a small quantity only
atimulates to nourishment. The following mixture is attenuant : —
Of pepper and Macedonian parsley, two parts, of asarabacca and
anise, one-half. This acts well, both as a diuretic and a cathartic.
LVIII. — How to recruit those who are Emaciated.
Whbn we wish to recruit those who are reduced in flesh, we
must give them thick wine and food containing thick juices, and
prescribe slow exercise and moderate friction, — in a word, every
thing contrary to the method we have been just describing. It
may also be of use to be pitched for three or four days. If one
go into the bath with an empty stomach, he ought beforehand to
get his body rubbed with linen cloths until it become ruddy, and
afterwards, by hard but not frequent friction, the skin may be ren^
dered thick and hard. Those who are pale, and not properly nourish-
ed» ought to be roused to anger and mental emotions.
LIX. — How to remedy emaciated parts of the Body.
Whbn emaciation takes place in any part of the body, it is com-
monly occasioned by long-protracted rest, or by bandaging for
fractures. We must, therefore, stimulate their vital powers, and
attract the blood to them, by using moderate friction, suitable exer-
cise» and pouring warm water upon them in moderate quantity.
This must be done until the part becomes red and swells, and we
must desist before it subside. We must also use pitching, as for-
merly described. When there is a sense of cold in the part, it ought
to be rubbed with linen cloths, or some calefacient medicine. For
this purpose, I have sometimes used the thapsia, rubbing it in either
with honey or cerate.
I4X. — Description of the best Temperament.
That man is in the best temperament of body when it is in a
medium between all extremes, of leanness and obesity, of softness
BOOK FIRST. 31
and hardness, of heat and cold, of 'moisture and dryness ; and, in a
word, who has all the natural and vital energies in a faultless state.
His hair, also, should be neither thick nor thin, neither black nor
white. When a boy, his lodiis should be rather tawny than b1ack»
but, when an adult, the contrarywise.
LXI. — Description of the Intemperaments.
Thosb bodies which are of a hotter temperament than the moder-
ate ¥nll have their teeth earlier than usual, and will grow in like
manner. They feel warmer to the touch, and have less fat ; they
are of a ruddy colour, have their hair black and moderately thick,
and their vems are large. But if such a one be also fat and
brawny, and have large veins, he is fat from habit and not from
nature. The following are the symptoms of a cold temperament :
Such bodies appear cold to the touch, are without hair, and are fat ;
their complexion, like their hair, being tawny. But when the coldness
is great, they are pale, leaden-coloured, and have small veins ; and
if lean, this does not proceed from nature, but habit. The dry is
harder and more slender than the temperate — the hardness, indeed,
being inseparable from the dry temperament ; but leanness not only
follows the connate temperaments, but also those which are ac-
quired by long habit. It is a symptom of hardness when the body
is rendered unapt for motion, dry and parched, by drpng applica-
tions. The humid, in all other respects, is like the temperate,
but is softer and fatter, and the softness is inseparable from it;
but the grossness not only follows the connate temperament, but
also that acquired by long habit. It is peculiar to the humid tem-
perament that the body is oppressed by things of a moist nature.
The warm and dry temperament is extremely shaggy, having the
hair of the head in early age of rapid growth, black, and thick ; but,
in after-life, baldness follows. The veins are large, as are likewise
the arteries, which beat strongly. The whole body is firm, well ar-
ticulated, muscular, and without obesity ; and the skin is hard and
dark. When the temperament is cold and humid, the chest is nar-
row, and like the rest of the body without hairs ; the skin is soft
and white, and its hairs somewhat tawny, especially in youth ; and
such persons do not get bald when they grow old ; they are timid,
spiritless, and inactive ; their veins are invisible ; they are gross and
fat ; their muscles and legs are feeble, and their joints ill-formed ;
and they are bandy-legged. But should the humidity and cold-
ness increase, the colour of their skin and hair becomes tawny,
or, if tiiey increase still more, pale. The hot and humid tempera-
ment is softer and more fleshy than the proper, and, when it in-
creases much, is subject to putrid disorders; but, if it be only a little
more humid and much hotter than the moderate, the bodies of
such persons are only a little more soft and fleshy than the mode-
nite, but they are much more hairy and hotter to the touch. But
if the cold and the dry grow equally together, such persons have
32 PAULUS iEGINETA.
naturally their bodies hard, slender, and white, with fine mnscles,
small joints, and little hair ; and they are cold to the touch. Al-
though slender, fat is mixed with their flesh. The colour of their
hair is correspondent to the degree of constitutional coldness. As
to disposition of mind, they are spiritless, timid, and desponding.
To say all in a word, with regard to the compound temperaments,
they are always to be distinguished by the marks of the prevailing
quality.
LXII. — On the Form of the Head.
A SMALL head indicates a faulty configuration of the brain, bat
a large is not necessarily a good one ; for if occasioned by the
strength of the vital powers of the part fabricating an abundant and
proper matter, it is a good sign ; but if occasioned by the quan-
tity of matter alone, it is not good. We must judge of heads then
from their shape, and from the processes which arise from them —
from their shape, if well formed, for that is always a good sign —
and from the processes of the brain, if they be in their proper state,
and if the tendinous parts be all properly nourished, have their suita-
ble tonefand if the sight be acute. Sharp heads are defective in the
protuberance of the front or hind-head, or else it is unnaturally in*
creased. Now, in most cases we shall find that these last, like the
large, are faulty, and yet some of them, though rarely, are good,
being occasioned by the strength of the formative principle.
LXIII. — How to know ike Temperament of the Brain.
A BRAIN of the proper temperament has its vital energies and ex-
cretions moderate, and is not liable to be affected by any externals.
Such persons, when infants, have the hair of their head somewhat
tawny — when boys, yellowish — and when adults, a bright yellow ;
being also intermediate between the curly and the straight, and
they do not readily fall out. When the temperament is hotter
than moderate, all the parts about the head are hotter and redder,
the veins in their eyes are distinguishable, their hair is grown at
birth ; and if much hotter, it is black, strong, and curly ; but if
not much, it is yellowish at first, and then grows black, and in
more advanced life such persons become bald ; their excretions are
small when they enjoy good health ; their head becomes filled and
oppressed by heating food, drink, and odours, or by any external
applications of the same nature. Sach temperaments are satisfied
with little sleep, and even that is generally not profound. The fol-
lowing are the marks of a brain which is colder than proper : — ^The
excretions are in large quantity; the hairs are straight, yellow,
and durable ; and it is hurt readily by cold things. Such persons
are constantly seized with catarrhs and defluxions, the veins of their
eyes are not visible, and they are given to drowsiness. The follow-
BOOK FIRST. 33
iDg are the marks of a brain which is drier than natural : — The ex-
cretions small, and the senses acute, not given to drowsiness, the hair
strong and soon formed, rather curly, and soon falling out. In the
more humid temperament, the hairs are straight, do not readily fall
out ; the senses are blunt, and the excretions redundant, sleep long
and profound. In the compound of the hot and dry, the excretions
of the head are small, the senses acute, there is a disposition to
watchfulness, and baldness. Their hair at first is formed quickly
and abundantly, is of a black colour, hot to the touch, and red until
manhood. But if moisture be joined to )^eat, and they are not im-
moderate, the colour and heat are good, and the veins of the eyes
large. The excretions are plenteous and well concocted. The hair
is straight and yellowish, and does not readily fall out. The head
is easily filled and oppressed by hot and humid things. But should
an increase of humidity and heat take place, the head becomes dis-
eased, and easily affected by heating and diluent things. Such per-
sons cannot endure long watchfulness, but their sleep is disturbed
by phantastical dreams, their sight is dim, and their senses not dis-
tinct. The cold and dry temperaments of the brain conjoined to-
gether render the head cold and pale, the veins of their eyes do not
appear, and they are readily hurt by cold things. Wherefore, their
health is precarious. Their senses in youth are distinct and fault-
less, but as they advance in life soon decay. In a word, as far as re-
gards the head« they experience a premature old age; their hair after
birth is of slow growth, dry and tawny. The humid and cold tempera-
ments of the brain render those affected with them prone to lethargy
and drowsiness ; their senses are bad ; they abound with recremen-
titious humours; are easily affected with cold and fulness of the head;
and are liable to catarrhs and defiuxions ; but do not readily become
bald.
LXIV. — Description of the Temperaments of the Stomach.
Thb symptoms of an unusual dryness of the stomach are, that
those affected with it are liable to thirst, but little satisfies them ;
and they are oppressed with much drink, as the superfluity occasions
gurgling in, or floats upon, the stomach ; of those of a more humid,
that they are not addicted to thirst, and bear readily much liquids,
and rejoice in humid food. A stomach unusually hot has a better
digest ipn than appetite, particularly with regard to those things
which are hard and difi&cult to change ; it delights in much food
and drink ; neither is it hurt by the moderate use of cold things.
An unusually cold stomach has a good appetite, but not a good
digestion, in particular with regard to such things as are difficult
to change, and are of a cold nature, which therefore are apt to turn
acid in it. And it delights indeed in cold things, but is readily
hart by the immoderate use of them. The bad temperaments pro-
ceeding from disease differ from the cengenital in this, that they
long for opposite things, and not always alike. If the stomach
34 PAULUg iEGINETA.
then digests properly, it is of a moderate temperament ; tnd if it
does not, it is of a bad ; but if its eructations are fetid , its heat is
inordinate and inflammatory ; but if acid, the contrary. And in
those who digest properly things of difficult digestion, the heat of
the stomach is inordinate, and weak in those who cannot digest
them, but digest fishes. It must also be observed, whether or not
the symptom is occasioned by any humour flowing from another
part ; for in pituitous constitutions acid eructations are apt to occur ;
but in the bilious, fetid airs and other disagreeable qualities are apt
to prevail. The common, sjrmptom of them all is nausea. If the
depraved humours are lodged within the cavity of the stomach, they
float on the surface, and are discharged by vomiting ; but if they
are contained in the substance of it within its coats, they annoy it
with vain attempts to vomit.
LXV. — On the Temperaments of the Lungs.
Not only does the stomach render us thirsty and otherwise, and
excite a desire of warm and cold drink, but also the thoracic vis-
cera, namely, the heart and lungs, and likewise the liver. And "
drinking does not straightway allay the desire, but a small quantity
of cold drink will rather allay the thirst than a great quantity of
warm. Persons so aflected are cooled by inhaling cold air, which
has no eflect in alleviating the thirst of the stomach. Thus, also,
those who are contrariwise affected suffer sensibly from breathing
cold air. This is the best indication of coldness of the lujigs, but
they hawk up phlegm, and expectorate it by coughmg. Dryness of
the lungs is marked by freedom from excrementitious discharges and
from phlegm ; and humidity, by being excrementitious, and render-
ing the voice dull and hoarse ; and the recrementitious discharge is
also very great when theyattempt to speak in a louder or sharper tone.
LXVI. — On the Ten^eramenta of the Heart.
Thesb are the symptoms of an unusually warm heart ; large-
ness of respiration, frequency and density of pulse, boldness and
maniacal ferocity , the chest is covered with hair, particularly the
breast, and usually, the parts of the hypochondriac regions adjoining
to it ; and the whole body is hot, unless the liver powerfully anta-
gonise. And capacity of chest is also an indication of heat, unless
the brain in that case antagonise. But an unusually cold heart
has the pulse smaller than moderate, and such persons are timid
and spiritless, more especially if there be no hairs on the breast.
Ihyness of the heart renders the pulse hard, and the disposition not
prone to anger, but fierce and difficult to quell ; and, for the most
part, the whole body is drier than usual, imless the liver antago-
nise. These are the marks of a more humid temperament ; a soft
pulse, a disposition easily roused to anger, and easily pacified, and
BOOK FIRST. 35
the ¥%ole body more humid than common, unless antagonised by the
liver. When the temperament is both hotter and drier, the pulse
is large and hard, quick and dense ; and the respirations large,
quick, and dense. Such persons have much hair upon the breast
and hypochondrium ; they are prone to action, given to anger, fierce
and tyrannical in their dispositions, for they are both passionate
and implacable. But, if humidity prevails with heat, such persons
are less covered with hair than the afore-mentioned ; they are prompt
to action, their disposition is not fierce, but only prone to anger ;
their pulse is large, soft, quick, and dense. But when the tem-
perament is more humid and cold than common, the pulse is soft,
the disposition spiritless, timid and sluggish ; they have no hair on
the breast, and neither indulge in lasting resentment, nor are prone
to anger. A cold and dry heart renders the pulse harder and small.
Of all others, such persons are least given to anger, but when pro-
vided they retain their resentment. They are also particularly dis-
tinguished by having no hair on the breast.
LXVII* — On the Temperaments qf the Liver,
Thx 83n3iptom8 of a hot liver are largeness of the veins, redun-
dance of yellow bile, and, in manhood, of black ; the blood hotter
than natiural, and by means of it the whole body, unless the heart
antagonise ; and thick hairs upon the hjrpochondriac regions, and
over the stomach. Those of a cold, are smallness of the veins,
much phlegm, cold blood ; the whole habit of the body colder than
common, imless warmed by the heart ; no hair on the hypochondriac
regions, nor over the stomach. Those of a dry are, thick and
scanty blood, and the veins and the habit of the whole body drier.
Those of a humid are, the blood abundant and liquid, the veins
softer, as also the whole body, unless the heart antagonise. The
symptoms of a temperament at once hot and dry are, the hairs very
thick on the hypochondrium, the blood at the same time thicker and
more scanty, a redundance of bitter bile, and, in manhood, of blacky
largeness and hardness of the veins, and the whole body hot and
dry* The heat proceeding from the heart may indeed overcome the
coldness proceeding from the liver, in like manner as the coldness
may the heat ; but it is not possible for the dr3mess to be changed
to the contrary state by the humidity of the heart. It is obvious
that* when the temperaments of those two prime organs combine to-
gether, the whole body is affected accordingly. But the humid
and hot liver, less than the hot and dry, renders the hypochondrium
shaggy ; but the blood is abundant, the veins large, and the whole
habit humid and hot, unless the heart antagonise. But, should
both these qualities be pretematurally increased, persons so affected
will be readily seized with putrid diseases and disorders from bad
bunours ; and more particularly if the humidity be much increased,
and the heat but little, they will be liable to cacochymies. In the
hwnid and cold, the hypochondrium is free from hairs, but the blood
D 2
36 PAULUS iEGINETA.
is pituitous, the veins contracted, and the whole body in like^an-
iier, unless changed by the heart to the opposite state. The cold
and dry renders the blood scanty, the veins of the body contracted,
and the body colder ; and the hypochondrium is without hair, un-
less the heart overcome this state.
LXVIII. — On the Temperaments of the Testicles.
Of the temperaments of the testicles, the hot is lustful, apt to
generate, particularly males, and has the genital parts covered with
thick hairs, which extend to the surrounding part. The cold is
the reverse. In the humid, the semen is copious and watery. In
the dry, it is scanty and thick. A temperament which is mode-
rately hot and dry has very thick semen, is most prolific, and
rouses the person to early indulgence. Such persons have, at a very
early period, thick hstirs on their genital organs, and on the sur-
rounding parts, as high up as the navel, and as low down as the mid-
dle of the thighs. Such a temperament is prone to venery, but is soon
satiated, and readily hurt if compelled. When humidity combines
with heat, such persons have thick hair, and much semen ; yet they
have not greater desires than others, but they can bear much ve-
nery without injury : and, if both the moist and the hot combine
properly together, they cannot safely abstain from venery. Those
whose testicles are of the humid and cold temperament have no
hair on the neighbouring parts ; they are slow in beginning to co-
pulate, and not much prone to the exertion. Their semen is wa-
tery, thin, without strength, and fit only for begetting females.
The dry and the cold temperament together resembles the former
in every other respect, except that the semen is thicker, and alto-
gether scanty.
LXIX. — On the Parts that are omitted.
Each of our members has its own proper temperament and fa-
culty ; but it is not necessary for us to describe the characters of
all, since they are unlimited, and we propose to give only a brief
system of instruction. Having treated of those which principally
affect the whole bbdy; of the others, we shall merely direct to
judge in the same way, forming an opinion of the temperaments
from their excretions, their other energies and symptoms. It is
now time to treat of the cure of the intemperaments of the whole
body.
LXX. — On the Cure of Hot Intemperaments of the Body,
Since, when hot intemperaments prevail, the bile exceeds in
quantity, if it pass downward, little, it is obvious, need be done ; but.
BOOK FIRST. 3/
if carried upwards to the stomach, it ought to be evacuated by vomit-
ing, by taking tepid water after exercise and before food. It will be
better that the exercise, be not swift nor hard ; but» on the con*
trary, rather slow and gentle. Some of those who are very hot do
not at all require gymnastic exercises, but walking and the bath are
sufficient for them. These delight also in baths after a meal. But
those who have heat combined with dryness require a diluent regi*
men by means of succulent food, baths, and abstinence from much
and hard exercise ; so that in the season of summer they ought to
bathe early, and after a meal a second time. Cold drink is of ser-
vice to them. Venery is most inimical to dry temperaments. Such
ought also to abstain from exertions producing, lassitude, exposure
to the sun, and to avoid cares and watchfulness. Those who are
naturally humid are apt in infancy to be seized with rheumatic and
plethoric complaints, and also with putrid. They stand in need of
more exercise, of a proper digestion, in the stomach, and of secre*
tions by urine. Wherefore such persons are much benefited by tak*
ing before diet the bath two or three times, particularly the natural
hot ones. They ought also to promote the secretions by means of
exercises, and the bath, and by procuring the alvine and urinary
discharges before taking food. And nothing hinders them to use
masticatories and cathartics, as also a whole&ome diet, and wine of
a diuretic quality.
LXXI. — On tfie Cure of the Cold hihmperaments of the Body,
Of cold intemperaments, there are three varieties, of which the
worst is the dry : for such persons are from the first in that state
which time brings upon old men. They ought, therefore, to use
whatever is diluting and warming, such as moderate exercise, hu-
mid and warm food, the heating wines, and much sleep. Care
should be taken, that all the excrementitious matters collected in
the body be evacuated every day. Venery hurts all those who are
affected with dryness, and more especially if joined to coldness, and
is innocuous to the hot and humid alone. The cold and humid
temperaments are bad, and are very subject to rheumatic afiections.
They are relieved by abstinence from the bath, by frequent and light
exercises, and the use of moderately warm unguents. Those that
are naturally colder, but are well regulated as to dryness and humi-
dity of temperament, ought to stimulate and increase their heat, but
to choose the medium between a humid and dry diet.
LXXII. — On the Cure of the Dry Intemperaments^ of the
Stomach for example ; then of the other Intemperaments,
A DRY intemperament may either be occasioned by the solid parts*
of uniform texture being drier than natural, which is incurable ; or
by the natural moisture from which these parts derive their nourish-
38 PAULUS JSGINETA.
ment being lost. It is contained in all parts of an animal, being
diffased tbrough them in the form of dew, and can only be supplied
by means of the food. The former variety is utterly incurable ; and
even the latter is of all states of the body the most intractable.
But when the dr3nie8s is seated in the small veins and arteries, the
cure may be attempted by filling each of the parts of uniform tex-
ture with their proper juices by a hnmid diet. A tepid bath is there-
fore beneficial, and the patient ought to remain long in it. Immedi-
ately after the bath, let him take the milk of an ass newly drawn,
to which a little warm honey has been added Afterwards he ought
to rest until he take a second bath. He ought then to be mode-
rately rubbed with oil, if the milk appears to be digested, which
may be judged of from his eructations and the detension of his
belly. The proper interval between the first and second bath may
be four or five hours at the equinox, if he be to bathe a third time,
but, if not, it may be greater. And he ought to be rubbed with oil
before putting on his clothes after every bathing. If^ therefore,
the milk agreed with him, we may give it to him after the second
time, or, if not, we may give instead a ptisan properly boiled, or
alica made into a ptisan. He is then to rest until the third bath-
ing, or, otherwise until supper. His bread ought to be carefully
prepared, baked in an oven, and of a fine quality. With the bread,
he may cat those fishes which are caught among rocks, or the had-
dock in a white soup. In a word, his food ought to be of easy di-
gestion and nutritious, not oily and excrementitious. His drink
should be wine that is weak, white, clear, bearing little water, and
having some astringency. Such is the mode of cure for the great-
est degree of dryness, but the moderate does not require the same
restriction as to diet, which may therefore be more generous. Let
us suppose a dryness like the former, but mixed with a moderate
coldness. In this case, we must substitute certain calefacient arti-
cles ; and, with regard to those mentioned above, we must add
more honey to the milk, and give wine that is not so watery. We
must also not only use things which are naturally heating, but which
are so from their acquired qualities. And the body is to be rubbed
frequently with the ointment of nard and mastich. When much
coldness is joined to the dryness, know, in the first place, that the
complaint is difiicult and intractable, but tise the san^ remedies,,
and also by itself honey that has been boiled and scummed, along
with very old wine. The best possible remedy is that which i»
much used by Pitchers ; and we must likewise rub the belly with
it, and tear it away while it is yet warm. Such persons are also
relieved by having a child of a full habit sleeping with them, so
as to touch their belly. Let us next suppose that a moderate heat
is joined to dryness. In this case, our first care ought to be, not to
taste honey, and to use wine which is not aged, food which is tepid
and milky, and to rub the belly with the oil of unripe olives, or with
that of apples. But to cool such persons much is not devoid of
danger, as the state is feverish when the heat prevails. Let us next
suppose that a hot intemperament prevails,^and that humidity is joined
BOOK FIRST. 39
to it. Such an intemperament is to be cured by drinking cold water.
The use of astringent food is also proper ; namely, such things as
are austere, without being heating. But when the humid intempera-
ment alone prevails, it is to be cured by such articles of food as are
desiccant, without heating or cooling much, and also by abstinence
from the common drinks. When the humid intemperament is joined
with the cold, the best remedies are all acrid things, and they ought
to be mixed with such things as are astringent, without being re-
frigerant. The drink should be in small quantity, and consist of
some of the strongly heating wines. These are the modes of cur-
ing intemperaments proceeding from qualities. But since a humour
contained within the cavity of the stomach, or being absorbed with-
in its coats, often occasions intemperaments, it will be proper to treat
also of these affections. If the former state occur at once, it may be
easily removed, by emetics ; but if it be a defluxion, the parts it comes
from will require very attentive consideration, and the cure will
follow, of course ; for it is to be applied entirely to the affected
part ; and of the other parts, we need only take care that they be
not thereby affected. The cure is to be performed by astringents,
and such things as will bring the body to its proper habit. De-
praved humours in the coats of the stomach, are to be evacuated by
moderately cathartic medicines, such as aloes, and the powder pre-
pared from it, called picra. When a viscid phlegm is contained in
the stomach, such persons ought to take those things which will
cut it, and then it may be purged off, or evacuated by vomiting
with radishes. When the humour is neither viscid nor thick, a
vomit from ptisan, or that from honied water, may be sufficient.
The juice of wormwood with honied water may also be drunk. In
like manner, intemperaments in other parts maybe cured, by finding
out the evacuation suited to the humours ; or, if the part has no
sensible discharge, the prevailing matter and humours may be
evacuated in the form of vapour ; and in like manner, if it proceed
from flatulence.
LXXIII. — On the Powers of the Articles of Food.
SiNCB an account of the properties of food is a part of the doc-
trine of Hygiene, we shall add that to the preceding, having premised
only a few remarks before delivering the particular rules on this
head ; for nothing is more indispensably necessary than to be well
acquainted with the properties of food. Things of an attenuating
power open the pores, and clear away the viscid humours which are
impacted in them, and cut and attenuate the thick ; but when per-
severed in as articles of food, they beget serous and bilious super-
fluities, or, if still longer continued, they render the blood melan-
cholic. One ought therefore to abstain from the continued use of
them, and in particular those who are of a bilious temperament ; for
they only suit with those who have collections of phlegm, and of
crude, viscid, and thick humours. Those of incrassating powers are
40 PAULUS .EGINETA.
sufficiently nutritious, and, if properly digested in the stomach and
liver, they form good blood, but occasion obstructions of the spleen
and liver. Of these some have only thick juices, as the dried lentil,
but some viscid, as the mallows ; and in some they are both thick
and viscid, as the testaceous fishes. An attenuating diet is safer
than an incrassating for the preservation of health, but yet, as it
supplies little nourishment, it does not impart tone or strength to
the body. One ought, therefore, to take some moderately nutri-
tious diet, when experiencing the effects of a deficient diet. They
may do so with the least danger who are given to exercises and can
take as much rest as they please. But all those who cannot take
exercise before food ought to avoid such things as are incrassating ;
and those who are of an indolent habit ought by no means to take
such food. For complete inactivity is one of the greatest evils for
the preservation of health, whereas moderate exercise is particularly
good. Those articles of food which are intermediate between the
incrassating and the attenuating are the best of all, producing blood
of a proper consistency. Such a diet, then, agrees with our bodies,
but that which produces a bad chyme ought to be shunned. It is
better also to avoid variety of food, more particularly if it consist of
contrary qualities; for such things, when taken together, do not
digest properly.
LXXiy.— On Pot'Herb».
The lettuce is manifestly refrigerant and diluent ; it is therefore
soporific, and, compared with other pot-herbs, nutritious, forming
blood of a very good quality. The endive is refrigerant and di-
luent, but less so than the lettuce. The mallows cool but not ob-
viously, they rather moisten and thereby loosen the belly ; and this
they do by means of the viscid juice which they contain. The beet
is detergent, and thereby softens the belly, but when eaten in great
quantity it occasions pain of the stomach : it removes obstructions
of the liver and spleen. The cabbage, when twice boiled before it
is eaten, binds the belly, but when only once boiled for a short time,
it rather loosens, if eaten with oil, sauce, or salts ; as its juice, still
more than the dried lentil, is of a purgative quality; and in particu-
lar the sea-cabbage is laxative of the belly, being manifestly saltish
and bitter. The sea- purslane-tree, possessing stronger saline qua-
lities, loosens the belly, and agrees better with the stomach than
the cabbage, from having a moderate astringency; it is also fitted
for forming milk and semen. The blite and orache (atriplex hortensisj
are succulent and laxative, but not nutritious. All the thorny tribe,
such as the golden thistle, the atractylis, and such like are stomachic,
except the artichoke (cinara), for, being hard, it forms bad chyme ;
and, therefore, it is best to take it boiled with oil, fish-sauce, and
coriander. The -parsley, the horse-parsley (Smyrnium olusatrum)^
the water parsnip, and the allsander, are diuretic ; but the allsan •
der is aromatic, and more acrid, diuretic, and emmenagogue, where-
BOOK FIRST. 41
as the parsley and horse- parsley are sweeter, and, therefore, agree
better with the stomach. The rocket (braasica eruca) is hot, and
forms semen ; and, therefore, rouses to venery and occasions head-
achs. The cress, basil {pcimum), and mustard, are hot and acrid,
particularly the cress; but all are of difficult digestion, injure the
stomach, and supply unwholesome juices. But the nettle is of subtil
parts, laxative, and of little nourishment. The tooth-pick-fennel
is like the shepherd's-needle, possessing astringent and bitter quali-
ties in no small degree ; it is beneficial to the stomach, so that those
who have lost their appetite may eat it with advantage in vinegar ;
but it supplies little nourishment to the body. All the wild pot-
herbs, as they are called, contain very bad juices. Cappers, how-
ever, whets the' appetite, removes obstructions of the liver and
spleen, and evacuates phlegm. It is to be used with vinegar and
honey, or with vinegar and oil, before taking any other food.
LXXV. — On Asparagi or Young Shoots.
Blitbs, lettuces, orachs, mallows, and beets, have the plant juicy,
but the shoot dry. The turnip, mustard, radish, cress, pellitory,
cabbage, and other hot things, have the plant of a dry, but the
shoot of a juicy nature. The shoots of the bushy shrubs, both the
marsh and garden, and that of the bryony, are stomachic and
diuretic, but of little nourishment, yet when digested they are more
nutritious than those of pot-herbs. Such also are the shoots of
the ground-bay.
LXXVI. — On Herbs tvith Esculent Roots.
Tub bunias or turnip, when eaten after being twice boiled, is nu-
tritious, no less so than other herbs, but when frequently taken it
engenders thick juices. The bulbi are astringent and detergent,
whet the appetite, strengthen the stomach, and evacuate the viscid
humours contained in the chest. When twice boiled, they are
more nourishing, but less expectorant, having lost their bitter prin-
ciple. They increase the secretion of semen, excite to venery when
liberally used, and occasion flatulence and griping. When eaten
with fish-sauce and oil, they are very sweet, do not create flatulence,
are nutritious and digestible. The garden and wild carrot, and
the caraway, have roots which are less nutritious than turnip, but
hut, manitestly aromatic, and diuretic. But when used too freely,
they supply bad juices, and become of difficult digestion like other
roots. Some call the wild carrot daucus ; it is evidently more diu-
retic than the other. The radish is of an attenuant and heating
nature ; but may be eaten before other food along with vinegar and
fish-sauce, to loosen the belly, but by no means after a meal. The
onion, garlic, leek, and dog-leek (ampeloprason) ,he\ng of an acrid na-
ture, warm the body, attenuate and cut the thick humours contained in
42 V PAULUS .fiGINETA.
it ; when twice boiled, they give little nourishment, but when un-
boiled they do not nourish at all. The garlic is more deobstruent
and diaphoretic than the others ; and the dog-leek being wild, is
drier than the common leek. Regarding pot-herbs in general, the
raw, when eaten, furnish worse juices than the boiled, as they have
more excrementitious juice. But those which are prepared for pickles
with brine or vinegar and salt are stomachic, and whet the appetite*
and discuss crude humours ; but are of difficult digestion, and sup-
ply bad juices when too freely taken.
LXXVIL — On Truffles and Mushrooms.
The truffle {tuber) forms chyme devoid of qualities, but cold
and thick. The mushrooms called myceta form phlegm and bad
chyme, being of a cold nature. Of these, the holeti are devoid of
qualities, and are safer than the others when bSiled properly. The
ammanita are of the second order. The other mushrooms ought
not to be tasted, for many of them are mortal poisons ; and even
the boleti, when eaten without being properly boiled, have often oc-
casioned danger.
LXXVIII.— 0» the Frumentaceous Articles of Food.
Of the frumentacea, the chondrus is nutricious, and forms viscid
chyme ; but a watery preparation is unwholesome, because, as it
thickens quickly, it remains raw and unconcocted ; but the juice of
it is better when it is properly boiled whole like a ptisan. The
alica in other respects resembles the chondrus, only that it binds
the belly more. Wheat, when boiled and eaten, is of difficult diges-
tion and flatulent ; but if digested it proves a very strong food.
When made into bread, its indigestible and flatulent properties are
removed by the yeast and salt which are added. The most nutri*
tious of all the kinds of bread is that made from siligo ; next, that
from the similago ; and, third, that which is composed of all to-
gether, and retaining the bran. Coarse bread is less nutritious,
but more laxative than the other kinds. Starch gives little nourish-
ment like washed bread. Barley is of a cold nature and detergent.
When boiled like a ptisan it humectates ; but when toasted, as in
polenta, it dries. Polenta in summer, drunk with water before the
bath, quenches thirst. Barley-bread is dry and of little nourish-
ment. The pudding (maza) is of more difficult digestion, and more
flatulent than barley-bread, and when it receives a little honey is
laxative. Oats are heating and of little nourishment. Millet and
panic are cold and dry, contain little nourishment, and bind the
belly. But the millet is in every respect superior to the panic.
Rice is of difficult digestion, contains little nourishment, and binds
the belly. A ptisan is prepared, by adding one part of it to fifteen
parts of water, then mixing a moderate quantity of oil, and after it
BOOK FIRST. 43
swells up, some vinegar. When properly boiled, a small quantity
of salt is to be thrown in, and sometimes leeks or dill may be added.
Oats and chondrus may be prepared similarly to this ptisan.
LXXIX.— 0» Pube.
Of pulse, the lentil forms a bad chyme and melancholic humours;
but, when twice boiled, it binds the beUy ; yet, its decoction when
drunk with oil and sauce is rather laxative. But savoury or pen-
ujtojbI ought to be added to it because it is flatulent. The com-
mon bean is light, flatulent, and detergent; but the Egyptian bean
is much more succulent and excrementitious than ours. The pea is
spongy, but not so flatulent. The chick-peas are flatulent and de-
tergent, promote the formation of semen, are aphrodisiacal, and H-
thontriptic ; when toasted, they part with their flatulence, but are
of difficult digestion. Lupines are difficult to digest and evacuate,
and produce a bad chyme. The fenugreek warms and loosens the
beUy when taken before a meal. TatBS and fasels having been pre-
viously macerated in water so as to shoot out roots, are laxative of
the belly when taken before a meal with sauce ; and are more nu-
tritious than the fenugreek. But the fasels callckl^ifo/tcAf, when
eaten green with their husks, are more excretnentitious.
LXXX. — On the 8ummer Fruits.
Ths gourd is of a cold and humid nature, loosens the belly, and
gives little nourishment. The pompion is altogether a fruit of bad
juices, cold, humid and emetic ; and, when not properly digested,
it occasions cholera. The seed of it is diuretic, breaks down stones
in the kidneys, and is altogether very detergent. The squash has
all the properties of the pompion in an inferior degree. The cucum-
ber is of a less cold and humid nature than the pompion, but is
more diuretic ; it is difficult to digest, and its chyme is bad even when
digested. Upon the whole, all this class of fruits are of a cold and
homid nature, supply little nourishment, and that of a bad quality.
LXXXI.— 0» the Fruit of Trees.
Thb fig and the grape hold the principal place in this class of
fruits ; for their juices are of a less bad quality, and they are more
mitritious than tiie others. — ^Of these, the figs have the better juices
and the more nutritious ; they are laxative, diuretic, and evacuate
the kidneys, and particularly the very ripe. In like manner also the
dried ; but they are flatulent, and form blood which is not good ;
wherefore, when liberally used, they engender lice. When grapes
are not evacuated, neither are they digested, but form a crude
chyme; but if evacuated their eflects are more moderate. Dried
grapes are wanner than the others, more stomachic, and more nu-
44 PAULUS ili:GIN£TA.
tritious, but not so laxative. The mulberry is of a moistening na-
ture, cools moderately, and loosens the belly when taken first, nei«
ther does it disagree with the stomach, but is little nutritious. — Of
cherries, the sweeter kinds loosen the belly, but are bad for the
stomach ; those which possess astringency are not so bad for the
stomach, but do not evacuate the belly. The same rule will apply
to the grape, the mulberry, and many other fruits ; for astringents
in general, when eaten or drunk at the beginning before any other
food, bind the belly ; but they who have their bowels constipated
from atony, and have taken some articles of food of a laxative na-
ture, such as pot-herbs, fishes, or the like, will find that astrin-
gents taken afterwards will, by strengthening the bowels, evacuate
downwards. The fruit of the pine called strobilus has good juices
and thick ; is nutritious, but not of easy digestion. The juices of the
peach are of a bad quality, turn acid, and soon spoil ; and, therefore,
ought to be taken first, that they may readily pass downwards, and
not spoil by remaining in the belly. The fruits called apricots are
superior to the peaches, for they neither turn acid nor spoil so soon,
and are sweet. Of apples, those that are sweet are more heat-
ing, and easier assimilated than the others, especially when roasted
or boiled ; the acid are colder and more calculated to cut the hu-
mours in the stomach; the austere strengthen the stomach and
bind the belly, more especially quinces. Of pears, the large and
ripe are more nutritious than these ; but the pomegranates are cool-
ing, and contain little nourishment. The medlars and services are
more astringent and fitted for a loose belly. Dates are stomachic,
unless very fatty, they bind the belly, form thick and viscid chyme,
and occasion headachs. Of olives, those called drupm injure the
stomach, and form a fatty chyme ; those that are pickled and hung
(halmadea et colynibadesj when eaten beforehand, whet the appetite,
and loosen the belly, more especially if prepared with vinegar, or
vinegar and honey. Of nuts, those called royal (walnuts) are less
nutritious than the filbert, and more stomachic. The green wal-
nuts are more juicy and laxative ; and, if you will strip off the inner
membrane of dried ones which have been macerated in water, they
will become like the green. Almonds have incisive and attenuat-
ing powers, and, therefore, they evacuate the intestines and chest,
and more especially such as are bitter ; and, in like manner, the
pistacs, which are also more calculated for removing obstructions of
the liver. Damascenes loosen the belly when eaten before food,
either xaw or boiled in honied water. The jujubes are of difficult
digestion, injurious to the stomach, and give little nourishment.
Carobs are of difficult digestion, bind the belly, and produce bad
chyme. Sycamores are decidedly of a cooling and a moisten-
ing nature. Of the citron, the outer part is acrid and indigestible,
but that part which is as it were its flesh is nutritious, and yet it
is hard to digest. The inner part, whether acid or watery, is mo-
derately cooling. Acorns are nutritious, no less so than com, but
of difficult digestion, contain thick juices, and are slowly evacuated.
Chesnuts are in every respect superior to them.
BOOK FIRST. 45
LXXXII. — On Animals; and, firsts of FovAs.
The nourishment derived from fowls is less than that from
beasts, and more especially swine, hut it is of easier digestion, par-
ticularly the partridge, wood-cock, pigeon, hen, and pheasant.
That from thrushes, hlackhirds, and small sparrows, (among whom
are those called pyrgitai) is harder ; and still more so the turtle,
wood-pigeon, and duck. But the peacock is still more indigestible,
harder, and more stringy. The flesh of geese and ostriches is ex-
crementitious, and more indigestible than any of the afore-men-
tioned ; except their wings, for they are not less wholesome than the
same parts in other animals. The flesh of the crane is stringy and
hard. In general, the yoimg are more juicy, digestible, and nutri-
tious than the aged, and are more readily evacuated by the belly.
The boiled are superior to the roasted and fricasseed ; and those that
live on dry and mountainous places are more digestible and less
excrementitious than those which live in marshy places.
LXXXIII.— 0» Effgs.
The eggs of hens and pheasants are the best of all ; those of
geese and ostriches the worst : of all animals, fresh eggs are su-
perior to the old. Those that are moderately boiled are most
nutritive ; those that are slightly boiled pass downwards most
easily, and smooth asperities in the throat. All the other kinds
are difficult to digest and evacuate, and contain thick juices, ex«
cept those that are said to be suflbcated. These are prepared by
mixing raw eggs with sauce, wine and oil, and coagulating to a
middling consistence in a double vessel. In this state they are of
easy digestion, and supply good juices. But of all others the fried
are the worst.
LXXXIV.-^On Beasts.
Among quadrupeds, swine's flesh is more nourishing than any
other food, because it is most nearly allied to the human in taste
and sm^ll, as some have declared who have tasted human flesh by
mistake. Bat the nourishment derived from it is viscid and imper-
spirable. That from sheep is excrementitious and supplies bad
juices. That from goats is acrid and has bad juices. But the
worst of all is the flesh of the buck-goat as to the quality of its
juices and to digestion. That of oxen forms melancholic humours ;
that of hares has thick juices, but less so than that of sheep and
oxeu. That of roes is hard and of diflicult digestion. In general,
the flesh of young beasts is more humid, softer, and more digestible
than that of the aged ; of gelded animals than of those having tes-
ticles ; and of the well-fed than of the lean.
46 PAULUS JilGINETA.
LXXXV.— On the Parts of Animals.
The extremities are tendinous, without fat and without flesh ;
and are therefore viscid, contain little nourishment, and are laxa-
tive of the belly, except those of birds owing to their great dry-
ness. The moat and ears are gristly and indigestible. The tongue
is spongy, full of blood, and gives little nourishment. The glands
are sweet and friable ; and those of the breast are sweeter than the
others, and, in particular, those of swine which are giving milk.
These are no less nutritious than the flesh. The kidneys and testi-
cles are strong-smelled and indigestible, but those of cocks fed upon
grain are sweet, and supply a good nourishment to the body;
whereas those of bulls, buck-goats, and rams, are indigestible, and
contain bad juices. The brain produces phlegm, thick and bad
chyme, is difficult to evacuate and digest, injurious to the stomach,
and occasions nausea ; but when properly digested it is sufficiently
nutritious. The marrow is oily and sweeter than the brain, but in
other respects resembles it. Fat and suet contain little nourish-
ment, and are hurtful to the stomach. The heart and liver contain
thick juices, are difficult to digest and evacuate. But the liver of
swine is better. The spleen contains bad juices, and occasions me-
lancholic humours. The lungs are more digestible as being spongy,
bat contain less nourishment and form phlegm. The stomach,
womb, and intestines are hard, indigestible, and form phlegm. In
general, the nourishment from wild animals is drier and less excre-
mentitiotts than that from tame. All blood is of difficult digestion,
especially the thick and melancholic as is that of oxen ; but that of
hares is esteemed very delicious, and many are in the practice of
boiling it with the liver, and some with the other viscera. Some
eat also that of young swine ; and even Homer was aware that the
blood of goats is eaten by certain people.
LXXXVL— 0» MilL
Milk, when digested, is nutritive, but is injurious to the gums
and teeth ; and, therefore, after taking it, one ought to rinse one's
mouth, first with honied water, and then with an astringent wine,
It also produces headach, occasions flatulence of the stomach, and
hypochondria, and engenders stones in the kidneys. The more
watery kind contains less nourishment, but is more laxative, while,
on the other hand, the thick is more nutritive, and moves the belly
less. That of the goat is of a middling consistence, as that of the
sheep is thicker ; and it, immediately after the ewe has brought
forth lambs, is thinner, but it afterwards becomes thicker and
worse.
BOOK FIUST. 47
LXXXVIL— On the Drinking 0/ Milk.
Hb who drinks milk ought to abstain from all other food until it
be digested, and pass downwards. It is best therefore to drink it in
the morning, newly milked, and to take no food after it, nor any
bard exercise, because this would make it turn acid. But it is
better to walk about gently, and rest between, without sleeping.
After doing this, the first part will be evacuated, and then one may
drink another part, and when it is evacuated another may be taken.
At first, therefore, it purges properly, not indeed from the rest of
the body, but what was contained in the belly. Afterwards it en-
ters the veins, and nourishes excellently, and is no longer evacuated.
In bilious defluxions, and colliquative diarrhaeas, the milk should be
given boiled. Boil it at first gently, and for a short time, so that
none of it may run over, and that part of it may be consumed. Af-
terwards it may be boiled more and more, taking care not to bum
it, nor convert it into cheese. This will be best guarded against by
boiling it softly, and clearing away what is separated by the agita-
tion. It may be agitated with a smooth and slender reed ; and, if it
boil at the lips, this h-oth may be cleared away with a sponge, for
often the part there spoils all the rest. The milk then, as is said,
ought to be boiled until it become thicker and sweeter than the raw.
And the thin and serous part may be dissipated by putting heated
pebbles into the mUk. Tliis is beneficial in defluxions of the belly,
and particularly in bilious ones.
LXXXVIII. — On Milk that has been separated into Parts.
By powerful boiling at a strong fire without smoke, the serous
part of the milk is separated from the caseous, and is then strained
through a sieve or piece of rag carefully, and to the serous part is
added a moderate quantity of honey, or of vinegar and honey, or
salts ; and it is given to evacuate the bowels in the quantity of two
sextarii to adults, and to younger persons not less than a sextarius.
And milk thickened by ignited pebbles or iron may be given with
advantage for dysenteries and alvine discharges.
LXXXIX. — On Cheese.
All cheese is acrid, occasions thirst, is difficult to digest, forms
bad chyme, and engenders stones. That is best which is new,
spongy, soft, sweet, and has a moderate share of salt. The opposite
kbd is the worst.
48 PAULUS iEGINETA.
XC.—On Fishes.
That all fishes are of a cold and humid temperament is obvious.
Those that are found among rocks are the best, being of easy diges-
tion, furnishing good juices, and being moderately moistening when
their flesh is not hard. Of those that do not dwell among rocks,
the most excellent are those that live in the sea, or where rivers meet
the sea. But still worse are those which are found in marshes and
stagnant parts of the sea. In particular, the pollard (capito) being
a sea fish, is moderately sweet, not very indigestible, furnishes good
chyme, but the blood formed from it is thin and weak. So it is
also with the barb (lupus). The surmullet, as being a sea fish, is
harder than the others, dry, digestible, nutritive, sweet, and free
of fat,
XCI. — On the Testacea.
Thb testacea in general form a saltish and crude chyme; but of them
the oysters have the softest flesh, and are most laxative. The che-
mae, purpuras, solenes, spondyli, buccinse, cochleae, and such like, are
hard. And those covered with a soft shell (crustacea) such as
the astaci, paguri, crabs, common lobsters, and tliose called squillse,
are of diflicult digestion, nutritious, and bind the belly when often
boiled in sweet water. The juices of all the testacea are laxative,
and therefore from the land snails, although their flesh be hard, in-
digestible, nutritious, and contains bad juices, some make a sauce,
with oil and pickle, which they use for opening the belly. The sea
urchins (echini) are moderately cooling, contain little nourishment,
and are diuretic.
XCII. — On the Molltisca.
Thb mollusca, such as polypi, sepise, and loligines, are hard and
indigestible, and particularly the polypi. Their juices are saltish,
but when digested they furnish considerable nourishment to the body,
XCIII. — On the Cartilaffinotis Fishes.
Of the cartilaginous fishes, the torpedo and pastinaca have soft
and sweet flesh, which passes readily downwards, is easily digested,
and proves nutritive. The rays (raitej, leviraiae, skates (squatina),
and the like, are harder and diflicult to digest, and more nutritious.
In general, those animals which have hard flesh are difficult to di-
gest, and contain much nourishment. When properly digested,
they furnish much and substantial nourishment.
BOOK FIRST. 49
XCIV.— On the Cetacea.
Thb cetacea, or whale species, such as the balaense, seals, zygseaae,
dolphin, and great tunnies, have hard and indigestible flesh, con-
taining thick juices. When pickled, they are more moderately so.
And of the other fishes, those which are most humid and excremen-
titions are most fitted for pickling ; but there is the same di£ference
in pickles as in the fishes .^om which they are formed.
XCV. — Oh the Properties of Wine.
He who has taken the subject of health into consideration ought
to be acquainted with the powers of wine. Wine in general is nu-
tritious, but that which is red and thick is more particularly so ; but
its juices are not good. The sweet also is nutritious, but not sto-
machic. The astringent is stomachic, but is distributed with dif-
ficulty to the parts of the body, and nourishes less. The white
nourishes lees still. Wine of a yellow colour is the best of all.
That which is old is more heating and desiccant than the new.
Such, in a word, are the properties of wine. But wine in general
resuscitates the natural heat within us, and therefore it improves
digestion, and forms good blood. And being of a penetrating na-
ture, it difinses the nourishment all over the body, and therefore it
recruits those who are emaciated by disease, for it gives them an
appetite for food. It attenuates phlegm, clears away the bile by
nrine, and imparts a good colour. To the soul also it communicates
gladness and pleasure, and improves the strength. Such are the
good efiects of the moderate use of wine. But its immoderate use
produces just the reverse ; wherefore, those who are drunk become
changed, are delirious^ and disposed to heavy sleep. On that ac-
count, such an immoderate use of wine ought to be avoided ; but at
greater intervals it may be drank liberally, for it promotes the dis-
charges by urine and perspiration. But it is better in such cases to
vomit, by taking, beforehand, of honied water, so that one may not
be injurcMl by it. When one has drunk largely, it is not proper to
take much of any other food ; but while drinking, one should eat
boiled cabbage, and tiMste ^ome sweet meat, particularly almonds.
These things relieve headach, and are not difficult to vomit. It is
also very proper to take the infusion of wormwood before drinking,
for of all things it is the best preservative from surfeit. If one ex-
perience any painful effects from wine, one should drink cold water,
and the next day again the infusion of wormwood; and by using
eiercise, friction, the bath, and restricted food, in this way get
restored to healths
£
50 PAULUS iEOINETA.
XCVI. — On Honey and Honied Water,
Boiled honey is rather nutritive than laxative ; but when un-
boiled the contrary. It agrees with cold and humid temperaments,
but in the warm it is converted into bile. Honied water does not
agree well with those who are affected with bitter bile, being con-
verted into bile. In such constitutions the honied water ought to
be very weak ; but it is not proper for those whose bowels are easily
affected. The honied water may be prepared by adding eight parts
of water to the honey, and thus boiling it until it cease from. froth-
ing. It is expedient also to clear away the scum as soon as
formed.
XCVIL— 0» Sleep.
It remains, after having treated of every thing connected with
diet, to say something of sleep, which is generally taken after every
other thing. Sleep, then, may be briefly defined a relaxation of
the vital powers, occasioned by a suitable humidity irrigating the
brain. When properly taken it may produce many good effects.
It digests the food, concocts the fluids, soothes pain, alleviates
lassitude, and relaxes that which is contracted. It is also calculate'
ed to produce oblivion of mental sufferings, and to rectify the dis-
tracted powers of reason. The most suitable season for sleep is
after a meal. But that during the day does not agree with all, be*
cause the time spent in sleep is not sufficient for the complete
digestion of the food ; and, when the digestion is interrupted unsea-
sonably, those who rise from sleep at noon are often troubled with
acidity and flatulence, and sometimes even with a gargling noise in
their bowels, unless from habit or sufficient rest these bad effects be
obviated. The best season for sleep is the night, for the humidity
and drowsy stillness of night contribute to perfect digestion.
Wherefore after these nocturnal slumbers we feel the most desire
for evacuation. The proper limit to sleep is the complete digesticm
of the food, as may be ascertained by the eructations, and by tap-
ping over the stomach ; after which it may be useful to awake in
order to evacuate the excrementitious renmins of the digestion.
XCVIIL— CM Watchfulness.
The cure of watchfulness in disease, whether proceeding from
pain, fever, or some acute sjrmptom, will be treated of under the
head of fevers, but we shall now treat of the watchfulness of those in
health. If their watchfulness proceed from sorrow, care, or any
mental emotions, we must endeavour if possible to remove the of-
fending cause, and then to divert the attention by agreeable sounds.
For this purpose, some seek after the gentle noise of waters, by
BOOK FIRST. 51
which they are soothed and lulled to rest. After proper digestion,
they should use baths especially in the evening, and a moistening
diet, such as lettuces and the like. They may also mix the green
leaves of the black poppy with condiments, and eat fish of easy di-
gestion. They should sdso use plenty of wine which is light and
not old. When about to go to bed, their heads should be anointed
with rose oil, or with oil in which the heads of poppies or mandrake
have been boiled. And the oil of dill not too old is soporific. I
have known rest succeeding suddenly to fatigue produce this effect.
Moderate coition will sometimes do the same. Others easily pro-
cure rest by having their head and ieet cooled. But if their watch-
fulness be occasioned by their stomachs being oppressed by the
quantity or bad quality of the food (and I have known this happen,
in like manner as in others it arises from an unseasonable absti-
nence or diminution of their accustomed food), this ought to be in-
quired into and the cause removed.
XCIX. — On Somnolency.
If, on the other hand, the sleep be profound and heavy, we must
abstain from frequent baths and cooling unguents ; we must use
masticatories, and upon the whole change the regimen for one of a
hotter, drier, and less nutritive character, because the afifection is
occasioned by a cold and humid matter irrigating the brain.
C. — The Epistk of Diocles on the Preservation of Health, —
IHocles to King Antigomie.
SiMCB of all kings you are the most skilled in the arts, and have
lived longest, and have become acquainted with all philosophy, and
attained the highest rank in mathematics, I, supposing that the
science which treats of whatever relates to health is a branch of phi-
losophy becoming a king and befitting to you, have written you
tins account of the causes of diseases, of the symptoms which pre-
cede them^ and of the modes by which they may be cured. For
neither does a storm gather in the heavens but it is preceded by
certain signs which seamen and skilful men attend to, nor does
any disease attack the human frame without having its precursory
symptoms. If, then, you will only be persuaded by what we say re-
gar&ng them, you may attain a correct acquaintance with these
things. We divide the human body into four parts, the head, the
diest, the belly, and the bladder. When a disease is about to fix in
Ihe head, it is usually preceded by vertigo, pain in the head, heavi-
ness in tiie eye-brows, noise in the ears, and throbbing of the tem-
ples ; the eyes water in the morning, attended with dimness of
sight; the sense of smell is lost, and the gums become swelled.
When any such symptoms occur, the head ought to be purged> not
indeed with any strong medicine, but taking the tops of hyssop and
b3
52 PAULUS iEGlNETA.
sweet marjoram, pound them and boil them in a pot with half a hae-
mina of must or rob, rinse your mouth with this in the morning
before eating, and evacuate the humours by gargling. There i»
no gentler remedy than this for affections of the head. Mustard ia
warm honied water also answers the purpose well. Take a mouth-
ful of this in the morning before eating, gargle and evacuate the
humours. The head also should be warmed by covering it in such
a manner as that the phlegm may be readily discharged. Those who
neglect these symptoms are apt to be seized with the following dis-
orders : inflammations of the eyes, cataracts, pain of the ears as if
from a fracture, strumous affectiopsof the neck, sphacelas of the brain ».
catarrh, quinsy, running ulcers called achores, caries, enlargement of
the ruvula, defluxion of the hairs, ulceration of the head, pain in the
teeth. When some disease is about to fall upon the chest, it is usually
announced by the following symptoms : there are profuse sweats over
the whole body and particularly about the chest, the tongue ia
rough, expectoration saltish, bitter, or bilious, pains suddenly seiz-
ing the sides or shoulder-blades, frequent yawning, watchfulness,
oppressed respiration, thirst after sleep, despondency of mind, cold-
ness of the breast and arms, trembling of the hands. These symp-
toms may be relieved in the following manner : procure vomiting
after a moderate meal without medicine. Vomiting also when the
stomach is empty will answer well, to produce which first swallow
some small radishes, cresses, rocket, mustard, and purslain, and then
by drinking warm water procure vomiting. Upon those who neglect
these symptoms the following diseases are apt to supervene : pleu-
risy, peripneumony, melancholy, acute fevers, phrensy, lethargy,
ardent fevers attended with hiccough. When any disease is about
to attack the bowels, some of the following symptoms announce its
approach. In the first place, the belly is griped and disordered, the
food and drink seem bitter, heaviness of the knees» inability to
bend the loins, pains over the whole body unexpectedly occurring,
numbness of the legs, slight fever ; when any of these occur, it will
be proper to loosen the belly by a suitable diet without medicine.
There are many articles of this description which one may use with
safety, such as beets boiled with honied water, boiled garlic, mal-
lows, dock, the herb mercury, honied cakes ; for all these things
are laxative of the bowels. Or, if any of these symptoms increase,
mix bastard safifron with all these decoctions, for thereby they will
be rendered sweeter and less dangerous. The smooth cabbage
boiled in a large quantity of water is also beneficial ; this decoction
with honey and salt may be drank to the amount of about four
haeminse, or the water of chick-peas or tares boiled may be drank
in the same manner. Those who neglect the afore- mentioned symp-
toms are apt to be seized with the following affections : diarrhcea*
> dysentery, lienter}% ileus, ischiatic disease, tertian fever, gout, apo-
plexy, haemorrhoids, rheumatism. When any disease is about to
seize the bladder, the following symptoms are its usual precursors :
a sense of repletion after taking even a small quantity of food, fla-
tulence^ eructation, paleness of the whole body, deep sleep, urine
BOOK FIRST. 53
pale and passed with difficulty, swellings about the privy parts.
When any of these 83rmptoms appear, their safest cure will be by
aromatic diuretics. Thus the roots of fennel and parsley may be in-
fused in white fragrant wine, and drank every day when the sto-
mach is empty in the morning to the amount of two cyathi, with
water in whidi carrot, myrtle, or elecampane has been macerated
(you may use any of these you please, for all are useful) ; and the
infusion of chick-pease in water may be drank in like manner.
These symptoms when neglected are commonly followed by these
diseases : dropsy, enlargement of the spleen, pain of the liver, cal-
culus, inflammation of the kidneys, strangury, distention of the
belly. Regarding all these symptoms it may be remarked that
children ought to be treated with gentler remedies, and adults with
more active. I have now to give you an account of the seasons of
the year in which each of these complaints occur, and what things
ought to be taken and avoided. I begin with the winter solstice. —
Of the winter solstice, — ^This season disposes men to catarrhs and
defluxions, until the vernal equinox. It will be proper then to take
such things as are of a heating nature, drink wine little diluted or
drink pure wine, or of the decoction of marjoram, and indulge in
vcnery. From the winter solstice to the vernal equinox are ninety
days. Of the vernal equinox. — ^This season increases phlegm in
men, and the sweetish humours in the blood until the rising of the
pleiades. Use therefore juicy and acrid things, take labour, and
indulge in venery. To the rising of the pleiades are forty-six days.
Of the rising of the pleiades, — ^This season increases the bitter bile,
and bitter humours in men, imtil the summer solstice. Use therefore
all sweet things, laxatives of the belly, and indulge but sparingly
in venery. To the summer solstice are forty-five days. 0/ the
summer solstice. — This season increases the formation of black bile
in men, until the autumnal equinox. Use therefore cold water, and
every thing that is fragrant ; and do not indulge in venery, or do so
more sparingly than is generally directed regarding these matters.
To the autumnal equinox are ninety-three days. Of the autumnal
equinox, — ^This season increases phlegm and thin rheums in
men until the setting of the pleiades. Use therefore remedies for
removing rheums, have recourse to acrid and succulent things, take
no Tomits, and abstain from labour and venery. To the setting of
the pleiades are forty-five days. Of the setting of the pleiades, — ^This
season increases phlegm in men until the winter solstice. Take
therefore all sour things, drink as much as is agreeable of a weak
wine, use fat things, and labour strenuously. To the winter sol-
stice are forty-five days.
COMMENTARY
ON THE
FIRST BOOK
OF
PAULUS iEGINETA.
I.— ON THB COMPLAINTS OF PREGNANT WOMEN AND THE
REGIMEN PROPER FOR THEM.
Hippocrates says that, when pregnant women long to eat coals and earth,
the likeness of these things appears on the head of the child. De Superfata-
tionef c. 8. — Galen likewise believed in the influence of the imagination of
pregnant women on the foetus in tUero. Ad PUonem. This belief was very
ancient, for it appears to be countenanced by the Jewish historian. — See
Genesis xxx. 37 — 39. Traces of this opinion may be found in Hesiod ; and
distinct allusion to it is made in the Cynegetics of Oppian. Lib. i. 327.
The story in the Mihiopics of Heliodorus respecting Chariclea, the white
daughter of the black King and Queen of the Ethiopians, bespeaks the pre-
valence of the belief at the time when this celebrated romance was written.
My limits do not admit of my tracing the history of this singular notion in
modem times. I may mention, however, that it was adopted by the celer
brated Sir Everard Home, in a late publication, on the existence of nerves in
ike placenta, — Philosoph, Trans, for 1825. Andreas Laurentius gives an
interesting statement of ancient and modem opinions on this subject, de
Mirab. Strum. Sanit,
The bird pica is mentioned by name(ictrTa) in the Aves of Aristophanes. —
See also Schol. in Aristoph, in Fac. 496, and Vesp. 348. — ^Aristoteles, H. A.v ii.
4, and Plinius, H. N, z. 41. Hardouin concludes, from Pliny *s account of
it, that it was the magpie.
On the disease — See Galenus, Hygieine, de Causis Sympt. i. 7. — Aetius,
XTi. 10. — ^Theophanes Nonnus, c. 213. — Moschion de Morh, Mulier. c.
27. — Eros apud Gynacia — ^Alexander Aphrodisieus, ProbUmata lib. ii. p.
73. — Pseudo-Dioscorides, Euporist, ii. 16. Rhases, ContinenSf lib. xi.
Avicenna, lib. iii. fen. 21, tr. 2. — Haly Abbas, Theorica, vi. 17. — Serapion.
tr.iii. 22. — ^Alsaharavius, Pract. lib. xxv. §. 2. c. 8. It appears to be the
nalacia of Pliny, H. N. xxiii. 56.
56 COMMENTARY ON THE FIRST BOOK.
Moschion defines the pica to be an appetite for unusual food, which bap-
pens to pregnant women at some irregular period ; being attended with a
collection of depraved humours and nausea. It occurs, he says, most com-
monly in the second month, but sometimes earlier, and sometimes later.
He recommends a restricted diet at first, then wine, dry astringent food,
cataplasms of a repellent nature, and bodily motion.
But the account of the disease given by Galen and Aetius is the fullest.
They derive the name either from the bird, as mentioned above, or from ivy
{klttos), because, as ivy entwines itself about various plants, so does this ap-
petite in pregnant women fasten upon a variety of improper articles of food.
It is attended with languor of the stomach, nausea, and loathing of food, bring-
ing on vomiting of bile or phlegm, anxiety, and pains in the stomach. All
these symptoms arise, they say, from a sanguineous plethora, brought on by
a suppression ot the menstrual discharge. They, therefore, recommend a
restricted diet, and moderate exercise when the woman was accustomed to
it. When the humour which infests the stomach is of an acid, acrid, or
saltish nature, they direct to give draughts of tepid water, in order to en-
courage vomiting ; they forbid ail sweet things ; and recommend an old sub-
astringent wine. When there is a loathing of food, they advise to tempt the
appetite with a variety of savoury things. To those who have a desire for
eating earth, they particularly recommend starch. When the fluid which is
vomited is of a thick and viscid nature, they recommend to give pickles,
radishes, and oxymel, for an emetic. TTiey also particularly direct to apply
astringent cataplasms and plasters to the prscordia.
As the practice of the other authorities is conducted upon similar prin-
ciples, we shall only mention them very succinctly. For the depraved ap-
petite which longs for earth, Serapion recommends aromatic spices, such as
cardamom, cubebs, and the like. For the coatinued romiting, Alsaharavius
directs to apply over the stomach plasters, containing the oil of spikenard,
mastich, quinces, wormwood, and the like, or a vessel filled with hot water ;
to give pomegranate seeds to hold in the mouth ; to make the patient take
gentle exercise, and abstain from all sweet things.
Alexander Aphrodisieus accounts for the disease in much the same way as
Galen and Aetius. He says that, when the menstrual fluid is suppressed, a
determination of it takes place to the stomach, until the foetus becomes as
large as to consume it.
Pliny strongly commends citrons for the cure of the disease.
For the Edematous swellings of the feet and legs, most of the other autho-
rities concur with our author in recommending astringent applications. The
anthyllis mentioned by him, is supposed by Sprengel to have been the cres$a
cretica»
We shall conclude our commentary on this chapter with an outline of the
directions given by Aspasia for the managementof pregnant women. Women
who have conceived are to be guarded from frights, sorrow, and all violent
mental perturbation. They are to avoid gestation in carnages, severe exercise,
inordinate breathing, and blows about the loins ; also lifting heavy loads,
•dancing, and sitting on hard seats. Likewise all acrid and flatulent food^
strong clysters, and too much or too little food and drink are to be avoided^
All discharges of blood, whether from the nose or hemorrhoids, are dangerous
in the pregnant state. Moderate and wholesome food, gestation in a sedan,
gentle walking, soft friction, and the exercise of spinning, are proper. About
the eighth month, which is the most critical period of pregnancy, the diet is
to be more contracted, and the exercise increased . If the belly is constipated
owing to compression of the rectum, occasioned by the enlarged oterus,
laxative food is to be given, such as ptisan and mallows. In the ninth month
the regimen is to be of a relaxing nature, and for this purpose the tepid bath
COMMENTARY ON THB FIRST BOOK. 57
is to be frequently taken, for it has a great effect in rendering parturition
easy. Aetius, lib. xvi. 12.
Our author borrows part of this chapter from Oribasius, and abridges th«
rest from Galen and Aetius.
II. ON THB NURSE.
This chapter is taken from Oribasicis, Sj/nops. v. 2.
Aetius gives somewhat fuller directions. He says, the nurse ouzht not to be
younger than twenty, nor older than forty ; should be free from disease, and
have breasts neither too small nor too large. When the breasts are too large,
they contain more milk than the child can manage ; and part being retained
spoils, and proves injurious to the child, and even affects the health of tho
nurse. When too small, on the other hand, they do not contain a sufficient
supply of milk. Large nipples, he remarks, hurt the gums, and impede
deglutition ; whereas, when too smaAl, they cannot be got hold of. The
nurse, he says, should be chaste, sober, cleanly, and cheerful. Lib. iv. c. 4.
The directions given by the other authorities are very similar to our au-
thor's.— See, in particular, Rhases, ad mansor, iv. 30. — Avicenoa Cantica, —
Averrhoes in Cant. p. ii. tr. 1 . Avicenna says, the nurse ought to be from
25 to 35 years old. Averrhoes says, from 20 to 30.
It appears to have been a general practice among the Romans, after they
became luxurious and effeminate, for the ladies of noblemen to consign
the care of their infants to wet nurses. Tacitus, in his elegant dialogue de
Oratoribuiy inveighs against this practice, p. 105, Ed. Barker. — See also a
spirited declamation on this subject, by the philosopher, Phavorinus, in the
Nodes Attica of Aulus Gellius, lib. xii. c. 1. It is to be lamented that, at
the present time, this unnatural mode of bringing up children is far from
being uncommon. It is animadverted upon in very striking and forcible
terms by the well-known William Cobbett, in a sermon on the following
text: — ** Even the sea-monsters draw the breast; they give suck to their
young ones." Lamentations iv 3.
III. ON THE nurse's MTLK.
This chapter is taken from Oribasius, Si/nop. y. 3, and Aetius iv. 3.
The method of trying the quality of the milk here recommended is men-
tioned by Aetius, Barytius (ap. Geopon, xviii. 20.) Dioscorides, Avicenna,
Haly Abbas, and Alsaharavius. It is approved of by Smellie (Midwifery,
vol. i. p. 285), and by Van Swieten (§. 1354, Comment.) According to
Avicenna, a child ought not to be allowed to take suck oftener than twice or
thrice in the day.— See, in particular, Haly Abbas, Pract. i. 21, and Alsaha-
ravius, Pract. tr. xxx. c. 3.
IV. HOW TO CORRECT VITIATED MILK.
Aristotle forbids wet nurses to drink wine. It is the same thing, he
adds, whether the nurse or the child drink it. De Somno.
Oribasius, Aetius, and Avicenna, give similar directions to our author's.
They all permit nurses to take a moderate allowance of animal food and wine.
When the nurse has too little milk, Aetius recommends to make her drink
ale, (Ztfthus.) He also approves of sweet wine, gruels prepared with fennel,
or green dill boiled with ptisan. When the milk is thin, he directs to ab-
58 COIIIISNTART ON THB VIBST BOOK.
staiD from baths, and to take food of a nutritive quality, such as fine brea'l,
the legs of swine, tender birds, the flesh of kids, and sweet wine. When the
milk is thick, he recommends frequent baths, and an attenuant diet. When
the milk is excessive, he directs to diminish the quantity of tlie food, and to
give what is less nutritive, and to make discutient applications to the breasts,
such as a linen cloth wet in vinegar, and to wash them frequently with warm
salt water, or the decoction of myrtle.
Hippocrates forbids the nurse to take things of an acrid, saltish, acid, or crude
nature. He recommends fennel, cytisus, parsley, and the hot bath as a gene-
ral regimen to nurses. De Mulieb.
Haly Abbas gives similar directions. He properly recommends to pre-
vent the nurse from taking things of a pungent, sour, and bitter nature.
When the nurse's milk is deficient, he directs to give her the milk of cows
and goats, fennel, lettuce, parsley, and the like. Fract. i. 21.
y. ON THB NURTURB OF THE CHILD.
This chapter is taken from Oribasius, Synops. v. 5.
The practice of giving honey to new-bom children is similar to that of
tlie common people in Scotlano, who give sugar and water in these cases.
Galen, in like manner, approves of the honey. He directs to sprinkle the
body of a new-born child with salt ; and afterwards to rub it every day with
oil. After the milk diet is given up, the first food to be administered, he
says, should be bread, and a^rwards pulse and flesh. He forbids the use
of veine, because the temperament of a child is hot and humid. Hygiene.
Aetius recommends to bring up the child upon milk for twenty months.
Moschion says, from eighteen months to two years will be sufficient. Avicenna,
like our author, mentions two years. It is stated by Selden, that the Hebrew
women gave suck to their children for two years. This practice is enjoined
in the Koran. Aetius is not so strict in regard to regimen as Galen ; he
allows to vary the milk diet, by giving occasionally soft eggs, mead, or
sweet wine diluted with water. Lib. iv. c. 28.
Moschion, Averrhoes, and Avicenna, approve of exercising the child in a
cradle, and of lulling him with music. When the cord falls off, Avicenna
advises to sprinkle the part with the powder of burnt lead.
Averrhoes disapproves of sprinkling the child's body with salt, as recom-
mended by Galen, Colliget. lib. ii. c. 6. He agrees with Galen, however,
in condemning the use of wine. He directs to give the child exercise every
day, after exercise, friction, and after friction, the bath. He forbids the use
of the cold bath, however, because it retards the growth. When the child
does not sleep, Avicenna and Averrhoes recommend to give him poppy in
his food. CanticGf p. ii. tr. 1.
Haly Abbas directs, when there is any malformation of the head, to reduce
it to its proper shape, and bind it firm. Like Galen, he recommends to
sprinkle the body of a new-born child with salt and powdered roses, to har-
den the skin. He directs to give the child, for the first two days, sugar,
triturated with the oil of sesame. He recommends the frequent use of the
tepid bath. He properly directs, not to expose the child's eyes to the strong
lieht of day, nor to allow him to sleep in a strong sun, for fear of injuring
his eyes. When a child cries, it is the duty of the nurse, he says, to find out
the cause, as a child never cries except when something hurts it. The most
common causes, he adds, are, heat or cold, fleas or gnats, hunger or thirst, re-
tention of urine or of the faeces. For retention of the urine, he recommends
to give melon seed with julep both to the x^hild and the nurse ; and, when
the child's bowels are constipated^ he directs to give the nurse laxative herbs.
coif MINT ABT ON THB FIRBT BOOK. 59
oil of olives, prunes, and so forth. It is clear, therefore, that he was aware,
that a child may be operated upon by medicines given to the nurse. Dr.
Cullen considers this practice to be altogether nugatory ; but general ex-
perience, both in the human species and in the inferior animals, has proved
the contrary. Haly Abbas, Fract. i. 20.
The directions given by Alsaharavius are very similar. He remarks that
violent crying may occasion a descent of the bowels.
Syrasis, one of the commentators on Avicenna, recommends the tepid bath
for young children, and food after it. He directs to exercise the child before
putting him into the bath.
From what we have stated, it will be seen, that the ancient physicians did
not approve of the cold regimen, absurdlyproposed by certain modem phi-
losophers as the most proper for infants. Tiiey also very properly forbade the
use of wine, a practice strongly reprobated by the celebrated Dr. Waters
house of America. Public Lecture, containing Cauiiont to Young Penom
concerning Healthy p. 29.
VI. ON THB BXANTHBIIATA, OB BBUPTI0N8 OF INFANCY.
This chapter is taken ^m Oribasius, Synoptiiy v. 6. See also Aetius,
lib. iv. 21. The exanthemata here referred to appear, properly speaking, to
be the ttropkuli of Dr. Willan, but the ancients used the term rather vaguely
for several eruptive diseases. See book 4th. The exanthemata appear to
be the '^ pustulae parvs'* of Eros, apud Gynaeia, p. 59. For the Arabians,
see in particular Haly Abbas, Fract, i. 20. — ^Avicenna, lib. i. f. 3. d. 1. —
Alsaharavius, tr. xxvi. c. 7 and 8. Alsaharavius describes two cutaneous
complaints of infency by the names of Alseafa and Alkaba, The former he
describes as consisting of pustules, which affect the heads of infants, and
sometimes the face. They are attended, he says, with a constant itching,
and occasion erosion. This appears to be the porrigo larvalis of Drs. Willan
and Bateman. He directs to shave the head, and to apply to it first a leaf
of blite (bleta vel betal) and afterwards an ointment composed of spuma
argenti, ceruse, and lye with rose oil and wax. The Alkaba is said to be of
the same nature, only that the fluid which runs ftx>m the pustules resembles
honey. This, therefore, must be the porrigo favosa. He directs to wash the
head frequently with a lotion made from maijoram, mint, or centaury ; and
then to apply an ointment composed of spuma argenti, ceruse, Armenian
bole, sulphur, almonds, and quicksilver; and also liniments of rose-oil and
vinegar, with the free use of the bath. As Dr. Willan remarks, he has de-
scribed the strophuli by the name of pustulae (bothor), tr. xxvi. c. 25.
He says of them : *^ Alise sunt albs, alise rubee, aliae nigrae, alise magns, alis
parvs et multee et panes?, alis fortis et acuti doloris, et mortiferce,'* &c.
It appears, therefore, that he applies the term in a very lax signification.
Rhases describes the exanthemata by the name of vesica. He recom-
mends to give at the commencement medicines for expelling the morbific
superfluity firom the inner parts, such as the decoction of dates or figs, with
fennel water. When the eruption is fiurly come out, he recommends baths
medicated with roses, myrtles, and the like ; after which, the child is to be
robbed with the oil of roses or of violets. De .^ritvd, Infantium, c. 19.
Lanfrancus, and the other medical authorities of that age, describe them by
the name of sopAa^t.
VII.— ON THB COUOH AND DBFLUXION OF INFANTS.
See Oribasius, Synop. v. 7, and Aetius, iv. 18. Aetius recommends
various lohochs or linctus. One of them consists of pine kernels, almonds,
linseed, liquorice juice, and honey.
60 COMMBNTART ON THE FIB8T BOOK.
Emetics and demulcents, such as gum arable and liquorice, are the reme-
dies recommended by Avicenna, lib. i. fen. 3. doct. 1.
Haly Abbas approves of lohochs containing almonds, honey, &c. Pract.
i. 20. Alsaharavius recommends various demulcents, and an electuary con-
taining poppy seed, tragacanth, and the seeds of citrons, to be taken in a
decoction of Sebesten plums. lie also directs to produce vomiting, by mak-
ing the patient swallow copious draughts of honied water. Tr. xxvi. c. 24.
Hhases recommends nearly the same remedies, de Morbis Infant, c. 18.
VIII. — ON PRURITUS.
See Galenus, Ht/g. lib. v. — Oribasius, Synop. v. 8. — Avicenna, lib. i.
fen. 3. d. 1. — Haly Abbas, Pract. i. 20. — Rhases de Morb. Infant, c. 19. —
Alsaharavius, Pract, xxvi. 25.
The account given by Oribasius is similar to our author*s. Synop. v. 8.
Alsaharavius properly directs to pay attention to correct the acrimony of
the nurse's milk ; to wash the child with decoctions of roses, myrtle leaves,
and the like ; if the pustules are of a dry nature, to rub them with oil of
sesame or of violets ; and, if humid, with an ointment made of wax, litharge,
and rose oil.
Rhases directs to make the nurse abstain from sweet and salt things, as
they inflame the blood ; and to put the child, into a bath medicated with
mallows, pearl-barley, fenugreek, gourds, &c.
Avicenna and Haly Abbas treat the complaint upon similar principles.
IX.— ON DENTITION.
See in particular Oribasius, Synop. v. 9, and Aetius, iv. 9. Ilippoci-ates
and Aetius recommend a jasper amulet. Hippocrates remarks that pains,
restlessness, and convulsions are apt to come on at the time of dentition, if
the child be plethoric, and his belly constipated. AphoriSy cum Comment.
Galeni,
Moschion directs to rub the gums of the child, after the fifth month, with
sweet oil, the fresh grease of a hen, the brain of a hare, and lastly with
boiled honey. When inflammation supervenes afterwards, he recommends
fumigations and cataplasms, and directs to restrict the food and drink of the
nurse. C. 119.
The directions given by Avicenna are similar to those of Moschion, lib. i.
fen. 3. doct. 1. Alsaharavius properly states that the best way to avoid dif-
ficult dentition is to guard against corruption of the food and drink, and to
abstain from emetics, acids, figs, &c. To remove the painful symptoms
attendant on dentition, he directs to rub the gums with olive oil, honey in
which aloes and gum arabic have been boiled, and the like ; to wrap the head
in soft wool, and to pour tepid water upon it. Pract. xxxvi. 19.
The treatment recommended by the other authorities is very similar. See
in j^rticular Rhases, iii. c. 13.
The only ancient authors who make mention of scarification of the gums
as a remedy for painful dentition are, Marcellus Sideta (Mcdicina ex Pisci-
bus) and Pliny, H. N, xxxii. 26. Both direct to do it with the sting of the
Pastinaca Marina.
Ambrose Par^ recommends to open the gums with a lancet in extreme
cases, but mentions the practice in such terms as shows that it was not com-
mon in his time.
Sprengel gives the history of this simple operation. Hist, de la Med.
§ xviii. c. 17.
COMMKNTAUr ON THB FIRST BOOK. 6L
X. — ON APHTHJB, OR THB THRUSH.
The aphtha appears to be the otcedo of Isidorasy Orig, iv. 8.
Our author copies from Oribasius, Synop, ▼. 10. See also Aetius, viii.
39. Aetius borrows his account from Graleo, who is very iiiU upon the
treatment of aphthee. He remarks, that recent superficial ulcers are easily
cui-ed, but that such as spread and are of a gangrenous nature are very dan-
gerous. He gives, at great length, directions for the composition of applic^-
tionsy suited to every modification of the complaint. When the pustules are
red, he directs to use washes of a moderately astringent and cooling nature ;
if yellowish, the same, but somewhat more refrigerant ; if whitish and pitui-
tons, detergents are to be used ; and, if black, the most powerful discutients.
For simple cases of the aphthae infantium, he merely recommends the flowers
of roses with honied water. Most of his remedies are astringents. De Med,
sec. Loc. lib. vi. In another work, he says that aphthae are occasioned by
the acrimony of the milk, and are to be cured with astringents. Comment,
in III, Popul,
Avicenna recommends at first washes prepared from the vegetable acids,
and afterwards astringents, such as galls, sumach, balaustine, &c. Lib.
i. fen. 3. doct. 1. See also Haly Abbas, Pract, i. 20.
Alsaharavius states that aphthae generally arise from the sharpness of the
milk. His general treatment consists in regulating the diet of the nurse, and
using washes principally of an astringent nature for the child's mouth.
When they are very painful, he directs to add to the washes the juice of
lettuce, endive, and the like. When they are whitish, he recommends to use
a powder consisting of myrtle, saffron, and sugar. Tr. xxvi. 20. Rhases'
treatment is quite similar, de Morbii Infantium, c. 14.
The author of the Euporiston, which has been falsely ascribed to Dios-
corides, recommends certain applications of a strongly escharotic nature,
such as the following: Of arsenic, p. i.; of burnt paper, p. iii.; or this, of
sandarach and rose-oil equal parts. Euporist, i. 82.
Psellus enumerates two kinds of aphthae, namely, the white and the red ;
the fonner, he says, is mild, the latter very dangerous. Poema Medicum,
XI. ON BZCORIATIONS OF THB THIGHS.
See in particular Oribasius, Synop, v. 11. — Aetius, iv. 24, and Avicenna,
lib. i. fen. 3. doct. 1. All recommend nearly the same astringent applications
for the Intertrigo of infants.
XII. ON DI8CHAR0BS PROM THB BARS.
Oribasius, Aetius, Avicenna, and Haly Abbas, recommend the same
treatment, which would seem to be very proper. Alsaharavius recommends
to apply wor)l soaked in a solution of alum, and to use injections, consisting
of solutions of nitfe (soda) in vinegar. Rhases makes mention of nearly the
same applications, de Morb. Infant, c. 9.
XIII. — ON SIRIASIS.
See Oribasius, iSynop. v. 13. — Aetius, lib. iv. c. 13. — Avicenna, lib. i.
fen. 3. doct.. 1, — Haly Abbas^ Pract, i. 20. Alsaharavius, Pract, xxvi. 9.
62 COMMENTARY ON THE FIRST BOOK.
Khases,(ie Morb, Infant, c. 5. — ^Pseudo-Dioscorides, Euporist. i. 9.— Alex-
ander Aphrodisieus, ProbUm i. 98. — Plinius, H, N. xxxii. 48.
Aetius and Avicenna agree in describing it as an inflammation and swell-
ing of the brain and its membranes, so as to occasion a hollow at the bregma,
and as being attended with ardent fever. The account given by the others is
very similar. All recommend cooling and astringent applications to the part.
According to Alexander Aphrodisieus, children are most subject to this affec-
tion, especially in the summer season ; for which he attempts to assign the
reason. He describes it as an inflammation of the membranes of the brain.
The author of the Euporiston recommends the juices of various cooling herbs,
as local applications. Pliny represents the heat of it as excessive. He says,
'' Siriasesque intotium spongia frigida crebro humefectata, rana inversa adal-
ligata efficacissime sanet, quam aridam inveniri affirmant."
Sprengel, treating of Paulus, says, ** II decrit fort au long Tinflammation
de la tete connue depuis long-temps sous le nom de Siriasis.'' Hist, de la
Med, § vi. c. 3,
XIV. — ON THE RBOIMEN OF INFANCY AND OF THE SUCCEEDING
AGES, UNTIL MANHOOD.
These simple but judicious directions, respecting the regimen of the differ-
ent periods orlife, are taken from Oribe^ius, Synap, v. 14. — or from Aetius,
iv. 29. Many of them are borrowed originally from Galen, Hyg. lib. i.
Similar directions are given at great length by Haly Abbas. He positively
prohibits children flrom taking wine. He insists that wine not only proves
prejudicial to health, but also deteriorates the morals, Pract. i. 22. Alsa-
haravius agrees with him in proscribing wine to children, Theor. xiii. 2.
Avicenna makes very judicious observations on this subject, but the greater
part of them are taken nrom Galen. He insists with becoming earnestness
on the propriety of attending to the regulation of the passions of the child, as
being conducive to his health as well as to his morals. As soon as the boy
is roused from sleep he is to be bathed ; then he is to be allowed to play for
an hour ; afterwards, he is to get something to eat, and then is to be allowed
more play. Afterwards he is to be bathed ; then he is to take food ; and, if
possible, he is to be prohibited from drinking water immediately after a meal,
as it has a tendency to make unconcocted chyle be distributed over the body.
When six years old, he is to be consigned to the care of a teacher, but he is
not to be compelled to remain constantly in school. And here, by the way,
I will digress to introduce the sentiments of Quintilian, the great Roman
authority, on all matters relating to education : ** Nee sum adeo imprudens
aetatum, ut instandum teneris protinus acerb^ putem, exigendamque plenam
operam. Nam id in primis cavere oportebit, ne studia qui amare nondum
potest, oderit, et amaritudinem semel prsceptam, etiam ultra rudes annos re-
rormidet.'' Inst. Orat. lib. i. Avicenna goes on to state that, at the age he
has then reached, he is to be more sparingly bathed, and that his exercise
is to be multiplied before eating. Like most of the ancient authorities, he
forbids to allow the child wine. Thus, he adds, is the regimen of the child
to be regulated until he reach the age of fourteen. Lib. i. fen. doct. i. c. 4.
Averrhoes gives very sensible directions on this subject. He forbids the
use of wine and ales until manhood. ColUget. lib. vi. 6.
XV. ON THE PREPARATORY FRICTION.
A MORE circumstantial account of the mode ofpreparing the body for gym-
nastic exercises is given by Oribasius, Med. Collect, vi. 13: It is .taken,
GOMMSNTART ON THB FIRST BOOK. 68
however, from Galen's 2d book of Hygiene. See a similar account in Actios,
lii. 1. and Avicenna, lib. 1. fen. 3, doct. 2. The object of it, according to
Alexander Aphrodisieus, was to soften the parts so that they might not be
niptured. Frob, i. 119. To rub the body with oil was a general practice of
the ancients before strong exercises of every kind. Hence Horace cbarac*
terises an inactive person by his dread of oil : ** Cur olivum sanguine viper*
ino cautius vitat r — that is to say, as his commentator Acron explains it,
^ Cur Titat olivum, id est oleum, quo unctus tutius natet et luctetur ?** The
poet alludes to the practice in another place : ^ Ter uncti transnanto Tiberim.'^
It appears from Martial that a composition of oil and wax, called eeromoy was
sometimes used for this purpose.
" Vara nee ii^jecto ceromate brachia tendis.*' — Lib, vii. Epiffr. 32.
According to Thucydides, the Lacedemonians were the first who rubbed
their bodies with oil before wrestling. Lib. i. c. 1 . Pliny mentions the use
of oil before the gymnastic exercises as a luxury introduced by the Greeks.
It appears from him that cheap aromatics were sometimes added to the oil.
He mrther relates, that some barbarous nations used butter instead of oil. H.
AT.xi. 41.
Athenseus mentions that Atitiochus Epiphanes supplied the wrestlers at
Daphne with oil of saffron, of marjoram, and the like. Deipn. lib. v.
Lucian makes Solon say to Anacharsis that oil produces the same effect
upon the living body as upon leather, softening it, and rendering it stronger
and less apt to break. Anacharsis,
Mercurialis gives a learned disquisition on the preparatory friction, in his
work, de Arte Gt/mnastica, lib. i. 8. Baccius approves very much of the
unction with oil previous to going into the bath. t)e Thermis, lib. iii. The
Roman emperors, and other luxurious persons, often made use of perfumed
ointments instead of oil. See Suetonius, in Vita Caligiday Lampridius, in
Vita Heliogabali. It would appear that under the empire the people of
Rome were supplied gratuitously with oil in their public baths. V. Lamp,
c. 24, and Burman, de V, R, c. iii.
XVI.-^ON BXERCI8B8.
The remarks of our author on the effects of exercise are exceedingly per-
tinent and comprehensive. See, in like manner, Aetius, iii. 2, and Oribasius,
Med. Collect, vi. 11. But Galen is the great authority on this subject, which
he treats of very folly and philosophically, in the 2d book of his Hygiene,
He agrees entirely with Hippocrates, in stating that the proper time for exer-
cise is before a meal, because, the excrementitious superfluities being thereby
evacuated, the body is in a fit condition for receiving a new supply. He
explains, however, afterwards, that it is after the digestion and distribution of
a preceding meal have been accomplished that exercise will be most proper.
Averrhoes, in like manner, insists upon this rule. Collect, § ii. c. 2. Dr.
Paris, by the way, states that this is the proper season for exercise. Al-
tbou^ he disapproves of exercise immediately after a meal, he does not
approve of taking it when the stomach is empty. — (On Diet,)
According to Haly Abbas, exercise is useful for three purposes : 1 . For
rousing the innate or natural heat, whereby the processes of digestion and
distribution are accelerated. 2. For opening the pores of the body, and
evacuating its superfluities. 3. For strengthening and rousing the animal
actions, by the friction it occasions. Theor, v. 2. Avicenna gives nearly
the same enumeration of the good effects of exercise. Haly Abbas forbids
to take exercise immediately after dinner. He adds, that exercise taken
64 COMMENTARY ON THE flRST BOOK.
immediately after a meal makes the food descend to the intestines, where it
is absorbed by the veins before it is properly concocted, and thereby the
liver becomes loaded vrith crudities. Pract^ i. 3.
Alsaharavius directs to take exercise before a meal, but advises not to con-
tinue it after one feels fatigued and languid. Theor, tr. ii. c. 2. The same
rule is distinctly laid down by Rhases, Continens, lib. xxxiii. Dr. Paris, in
like manner,, directs not to carry exercise the length of occasioning fatigue.
He mentions that he had known many valetudinarians who, seeking to im-
prove the state of their stomachs, by taking exercise before a meal, had de-
feated their end, by carrying it tlie length of fatiguing and weakening the
powers of the system. — (On Diet.)
It appears that, instead of taking exercise after food,^ the ancients were in
the practice of indulging in a short sleep after their dinner or mid-day meal.
See Plautus, MostelL ac. iii. sc. 2. 1. 8, and the note of Meursius. Ed.
Gronov. Homer says that it is beneficial to old men to indulge in sleep
after the bath and taking food. V. Galen. Hi/g, lib. 1.
Plutarch mentions that Cicero was cured of debility of the stomach by
taking moderate exercises. In vita Ciceronis.
It was one of the extravagant opinions of the otherwise justly<^elebrated
Erasistratus, that exercise is not at all necessary for the health of the animal
frame.
Hieronymus Mercurialis gives many pertinent remarks on the ancient
exercises. De Art. Gymnastica^ lib. iv. See also Baccius, de ThermiSf lib.
vi. and Vossius, de Natura Artium, lib. i.
XVII. ON THE KINDS OF EXERCISE.
We shall now give a brief account of the ancient exercises, some of which
are altogether omitted by our author.
The a-Kiofrnxui is thus explained by Cornarius : " Porro a-Kiofiaxuip acci-
pio umi)ratilem pugnam, quk quis privatim . dpmi aut sub umbra, non in
propatulo se exercet, ac veluti prsparat ad justam pugnam publice facien-
aam." Nota in Paul. .^in. h. I. This account, however, does not agree
with that of Oribasius, who describes it as a mock encounter at boxing and
jumping with one's own shadow. Med. Collect, vi. 29. It is thus described
in the Latin translation of Avicenna : '* £t ex eis est, insequi umbram suam,
ut ipsam percutiat in capite, et manus ad invicem percutere.'' Lib. i. fen. 3.
doct. 2. c. 2. It is mentioned in this sense by Plato, de Legibus, lib. vii. ;
and by Plutarch, Frohl. Conviv. lib. vii. Juvenal probably alludes to this
sport. Sat. vi. 246. I have therefore translated it, " fighting with one's
own shadow."
The aKpoxfipio-fios is thus described by Scaliger : '' Est autem aKpoxfip^C^uf
luctae pars, cum primoribus tantumdigitis insertis roboris faciunt pei-iculum."
PoeticeSy lib. i. c. 22. Suidas explains it thus : XafAfiopofuvos yap oKp&p rap
X€ip&v Tov carrayovurrov tiCKa^ Kui ov nporepov ^(jnei irpiv diarooiTO oTroyo-
peva-avTos. The term occurs in Aristotle, Eth. Nicom. iii. 1. See also,
Athenseus, Deipnos. iv. 13. It is called oKpoxtipuns by Hippocrates, De
Diata.
The exercise with the K&pvKOSf or leather bag, is described by Oribasius in
the following manner : A bag filled with flour or sand was suspended from
the top of the house, on a level with the navel ; it was then pushed forwards
with the hands to the extremity of the rope, and, as it recoiled, the person
performing the exercise retreated backwards, so as to escape from it. Med.
Collect, vi. 33. This exercise is mentioned by Hippocrates, De Diwta, lib.
ii. Cornarius confounds it with the /o//is of the Romans; but Mercurialis
COMMBNTAK7 ON THE FIRST BOOK. Gj
clearly shows that they were quite different. The follis was a leather ball,
inflated with air: such is the description of it by Ccelius Aurelianus, *' Follis
erat piia magna ex alutli confecta, soloque vento repleta.'' Martial repre-
sents it as a becoming exercise for boys or old men :
Ite procnl juvenes, mitis mihi conveoit tetas,
FoUe deoet pueros ludere, foUe senes. — Epiyr, ziv. 45.
They were different from the pila magna and parva. These are minutt ly
described by Oribasius, Med. Collect, vi. 32. See also Horace, Sat. ii. 2, and
Martial, EpigrAy. 15. See a most learned and accurate account of all these
sports in Mercurialis, de Arte Gymnaitkay lib. ii. c. 4. Galen wrote a trea-
tise on the exercise of the parva pila. To this class we may refer the pitch-
ing of a »ton€, which is mentioned by Avicenna.
Our author has neglected to make mention of the halteres in this place,
but recommends the exercise for the cure of elephantiasis, lib. iv. c. 1 . The
exercise with them is thus described by Potter : " The exercise of leaping
they sometimes performed with weights upon their heads or shoulders, some-
times carrying them in their hands ; these were called oXr^pcr, which, though
now and then of different figures, yet, as Pausanias reports, were usually of
an oval form, and made with holes, or else covered with thongs, through
which the contenders put their fingers." Antiquities of Greece, c. 20. Mer-
corialis describes them as masses or weights of different materials, and of
such a size as that they could be held in the hands. Ropes, too, he adds,
were often fastened to them, to hold with. De Arte Gymnasticuy ii. 12.
The Pythagoreans were fond of this exercise. Iambi ichus, de Vita Pytha-
gora, c. 21.
The funambulatio consisted merely in scaling ropes, which, as we may
suppose, was done in various ways. See Mercurialis, iii. 5, and Baccius,
de ThermiSf viii. 7.
The €«arXe^pi^€iv, as Galen and Avicenna explain, consisted in running
round the plethrum, or sixth part of the stadium, and always contracting the
circle of one's course, until one stopt in the middle. The irirvXt^ctv, as the
same authors explain, consisted in walking upon one*s toes, and tossing one*s
hands backwards and forwards.
The cricilasia appears to have been a large hoop, or circle, which was rol-
led on the ground. Even Mercurialis admits the obscurity of Oribasius's
description of it, Med. Collect, vi. 26.
The petaurum was a seat suspended by ropes, in which seat the person
taking the exercise sat, and was tossed about by assistants. It is mentioned
by Juvenal, Sat. xiv. and Martial, Epigr. xi. 22. «
Antyllus thus describes the effects of equitation on the human frame : '' It
strengtiiens the body, especially the stomach, more than any other mode of
exercise ; it clears the organs of the senses, and renders them more acute ,*
but it is most inimical to the thorax.*' Oribasius, Med. Collect, vi. 24.
Pliny (H. N. xxviii. 4.) and Aetius agree with Antyllus as to the good
effects of equitation on the stomach. Hippocrates and Ccelius Aurelianus
state that equitation is hurtful in disease of the hip-joint. All agree that
riding on horseback is hurtful to diseases of the chest.
Of oi&poy or gestation, there were various modes. That in a carriage was
very ancient, and is often mentioned by the medical authors. It appears
from Pliny (H. N. xvi. 42.) that carriages were generally made of fir, and
that the axles were of ilex, mountain ash, or elm. Sometimes, however, the
whole chariot was adorned with gold and silver, (Pliny, H. N. xxiv. 17.)
They appear to have been often covered in with skins, (Plutarch, Prob.
Roman.) They were generally drawn by horses or mules, sometimed by
oxen, and occasionally by slaves. Th6y were so constructed that a person
F
C6 COMMENTARY ON THB FIRST BOOK.
could either sit or lie, according to pleasure, (Galen. Ht/g.) At first, accord-
ing to Pliny, they had only two wheels ; the Phrygians, he says, added two
more ; and Hippocrates mentions, that the Scythians introduced the use of
six-wheeled carriages. The sedan and chair are often mentioned by the
Latin poets, as well as by the medical writers. It is sufficient for our purpose
to state, that they were so constructed, that one could either sit or lie in them.
They sometimes had windows, formed from the lapis specularis. Juvenal,
Sat. iv. 21. Navigation, or sailing in ships and boats, is often mentioned by
ancient authors as a remedial measure. It was practised on the sea, or in
rivers. According to Aetius, gestation in general ventilates the natural beat,
produces excitement, dispels collected humours, strengthens the frame, and
rouses the actions when m an indolent state. Lib. iii. c. 6. Celsus has art
interesting chapter on gestation. The following rule for the application of it
is very judicious : ^* Gestatio quoque longis et jam inclinatis morbis aptissi-
ma est; utilisque est et iis corporibus quae jam ex toto febre carent, sed adhuc
exerceri per se non possunt ; et iis quibus lentae morborum reliquiae rema-
nent, neque aliter eliduntur." Upon the whole, he holds it to be a doubtful
practice in ardent fever, although sanctioned by the authority of Asclepiades :
at all events, he insists that gestation is improper when there is any local
pain or swelling. After characterising the different modes of gestation, be
remarks respecting them: — ^** Levia quidem genera exercitationis infirmis
conveniunt : valentiora vero iis qui jam pluribus diebus febre liberati sunt-;
aut iis, qui gravium morborum initia sic sentiunt, ut adhuc febre vacent,
quod et in tabe, et in stomachi vitiis, et cum aqua cutem subiit, et interdum
in regio raorbo fit ; aut ubi quidam morbi, qualis comitialis, qualis insania
est, sine febre, quamvis diu, manent.'' Lib. ii. c. 15.
Galen eulogises hunting as being an excellent exercise to the body, and an
agreeable recreation to the mind. He says, that by the mental excitement
which it produces, many have been cured of dangerous diseases. X)c parva
pita. Rhases mentions, that during the prevalence of a certain pestilential
epidemic, it was observed, that huntsmen were the only class of people who
escaped its contagion. Continens, lib. iii. The ancients have transmitted
to us many elegant treatises, both in prose and in verse, on this delightful
recreation. Those of Xenophon, Oppian, Gratius, and Nemesianus, will be
found particularly interesting. The younger Pliny attributes his recovery
from a certain complaint, to the exercise of hunting. Epkt. lib. v. 6.
The occupation of fishings according to Plato, produces neither mental
nor bodily excitement. In Sophisfa. Galen and Avicenna briefly mention
it, as an exercise which may tend to the preservation of health ; but neither
of them appears to have attached much importance to it. The poet Oppian,
however, nas celebrated the pleasures and dangers of fishing, with all the
enthusiasm of an Isaac .Walton, or a Washington Irving.
Oribasius states, that swimming tends to warm, strengthen, and attenuate
the body. He says, that swimming in the sea is particularly applicable in
cases of dropsy, eruptive diseases of the skin, and elephantiasis. It is apt,
however, he adds, to prove injurious to the head, and also to the nerves when
too long continued. We have mentioned in the 15ih Chapter, that the an-
cients got their bodies rubbed with oil before going into the water. Celsus
gives nearly the same account of it, as a remedy for the cure of diseases, as
Oribasius.
Jumping and dancings according to Oribasius, occasion a determination
downwards, and hence, they may prove useful in cases of amenorrhea. Med.
Collect, vi. 31. It appears from a case related in a work attributed to Hip-
pocrates, that jumping was had recourse to, to procure abortion. Dertnt.
pueri. The pyrrhic dance of the ancients was particularly celebrated. It
was performed by armed men. — See Vossius, de naf. art. lib. i.
COmilNTABT ON THB FIRST BOOK. G7
On the Apotherapia or Restorative process.—- See Galenus, Hyg. iii. Ori-
basius, Mea. Collect, vi. 16, and Avicenna, lib. i. Fen. 3. D. 2. It consisted
simply in mbbing the body softly and moderately with oil. According to
Galen, the object of it was to relieve the feelings of lassitude, and prevent
any l>ad effects from the exercise. Mercurialis states, that when applied after
the bath, it was with the intention of preventing the humidity from being
dissipated. Odoriferous ointments and powders were sometimes used, in-
stead of the oil. De arte gymnasticOf lib. i.
XVIII. ON THB MODBS OF FBICTION.
HiPPOCRATEs's brief, but comprehensive rules for the application of fric-
tion, are tbus given in the language of Celsus : — " Hippocrates dixit, fric-
tione, si vehemens sit, durari corpus ; si lenis, molliri ; si multa, mioui ;
si modica, impleri.'' Celsus adds, that according to circumstances, the body
may be braced by it, if relaxed ; may be softened, if indurated ; may have its
superfluities expelled, if loaded with plethora, and have nourishment attracted
to it, if emaciated. He remarks, that it is mostly applicable in the decline of
a disease. His other directions for the application of it are very apposite.
Lib. ii. c. 14.
Pliny delivers the rules of Hippocrates in nearly the same words as Celsus.
H. N, xxviii. 14.
Our author's account of friction is taken from Oribasius. Med. Collect.
lib. vi. or from Aetius, lib. iii. All, however, are indebted to Galen, who
handles the subject most scientifically. Hyg. lib. ii. *
Similar directions are given by Avicenna. Lib. i. fen. 3. Doct. 2. and
by Haly Abbas. Theor. v. 12. Averrhoes gives the sum of the directions
liud down by Galen and the other authorities. Strong friction, he says,
braces and hardens the body ; weak, rarifies and softens ; moderate, operates
in an intermediate degree. Besides, he adds, hard friction diminishes obe-
sity ; moderate, on the other hand, tends to remove emaciation. Collect, ii. 3.
It was a general practice of the ancients to have recourse to friction in the
momiog aim evening. Oribasius has many excellent observations on this
practice, u. s.
Dr. Paris remarks, '' the ancients are well known to have held friction in
high estimation, not only in the cure, but for the prevention of diseases. The
modems have unwisely suffered the practice to rail into disuse.'* On Diety
p. 362.
XIX. ON YOCITBBATION, OB THB EXBBCISB OF THB VOICE.
Th£Se remarks of our author are very pertinent; but Oribasius has given
amoreoomprehensive view of the subject, from the works of Antyllus. He
thus describes the mode of performing vociferation. The bowels being
eracoated, the person's body is to be first rubbed, and then the inferior parts
and the fi^ are to be sponged with water : He is to begin talking, at first, in
t moderate tone, while at the same time he walks about, and afterwards
straining his voice to a louder tone,. he is to repeat certain verses. Med.
Collect, lib. vi.
Plutarch gives nearly the same account of it. He commends vociferation
as giving strength to the internal parts, increasing the vital heat, purifying
the veins, attenuating the blood, and dispelling the humours. He cautions,
however, net to strain the voice to too great a pitch, lest it occasion rupture
of any of the vessels. De sanitate tuendd.
f2
68 COMMENTARY ON THE FIRST BOOK.
Vociferation, according to Aetius, is an exercise of the chest and tl>e organs
of speech, improving the vital heat ; attenuating and strengthening the solid
parts of the body. He recommends it for the cure of asthma, orthopnsa,
phthisical, and chronic pains of the chest, or aposthemes ^hen they burst;
also, in tertian intermittents, and affections of the stomach attended with vo-
miting. It is unsuitable, he says, in complaints of the head. Lib. iii. c. 5.
Celsus recommends loud reading for curing weakness of the stomach.
Ijb. i.8.
Galen scarcely takes any notice of vociferation, except, that in one place,
he states, that it exercises the chest and lungs. De sanitate tuenda. Lib.
ii. 11.
Avicenna, in giving an account of vociferation, follows Aetius. He says,
that it exercises the parts about the mouth and chest ; and hence, that it im-
proves the complexion. He likewise cautions not to prolong loud enuncia-
tion, lest it occasion a rupture of the vessels. He directs to begin moderate,
and then strain the voice gradually, and afterwards to allow it to sink by de-
grees. Lib. i. fen. 3. doct. 2.
XX. — ON LASSITUDE FROM EXERCISES.
There is a short treatise on this subject^ among the minor works of Theo-
pbrastus. He states, that, as the excess of motion in this case has produced
a preternatural dryness of the body, the indication of cure is to humectate,
that is to say, to dilute by baths and drinks. The work contains many in-
genious observations; but our limits do not admit of our giving a proper out-
line of it.
Our author copies from Oribasius, Synops. v. 15. — See also, Aetius, iv. 55.
el seq. They all, however, are indebted to Galen, de sanit, tuend. Lib. iii.
c. 7. The ulcerose lassitude, he says, arises from a collection of excremen-
titious superfluities, which are produced by the melting of fat and muscle, lu
the second species, called the tensive, there is no collection of humours, but
the muscular fibres are excessively stretched. The third species, or the inflam-
roative, is characterised by a sensation, as if the parts affected were bruised
or inflamed, and happens when the muscles being excessively heated, attract
the superfluities from the surrounding parts. From the pain being deep
seated, is has been called ostalgia. He adds a fourth species, being a case
somewhat different from all those we have been describing. It is the contrary
state to that of the inflammative, the body appearing squalid and contracted.
The first case, as it is connected with redundance of humours, is to be cured by
discutients ; and hence the proper remedy for it, is much friction, with
emollient oils, wholly devoid of astringency. He also approves of the gentle
exercise, called the restorative. The second species, or the tensive, is to be
cured by gentle friction, with emollient oils heated in the sun ; by complete
quietude, and the frequent repetition of the tepid bath. In particular, unction
with oil is proper. The third species, as it is occasioned by violent motions,
and is attended with excruciating pains, is to be cured by the gentlest friction,
with the most emollient oils ; by the most perfect rest, and the tepid bath.
The fourth species, characterised by squalor and constriction of the skin, is to
be treated by the hot bath, to warm and invigorate the skin, then soft and slow
molions and friction ; and then again by the hot bath. But, he adds, the
patient must straightway leave the cistern of the hot bath, and plunge into
that of the cold. He directs not to remain long in it. The diet in all these
cases, is to be restricted and cooling, especially in the inflammative.
As all the subsequent authorities, whether Greek or Arabian, adopt the
views of Galen, I need not enter into thedetail of their plans of treatment.
COMMBNTART ON THE FIB8T BOOK. 69
See Psellus, Opus Medicum. — Ai^icenna, lib. i. fen. 3. doct. 2. — Rhases,
Continens, xxxi. — ^Alsaharavius, Pract. xxxi. 11.— Averrhoes, CoUiget, vi. 8.
Collect, ii. 15. The bath, emollient friction, diluent food, and quietude, are
the remedies generally recommended by all the ancient authorities ; and they
are directed with a nice discrimination that cannot be too much admiredf.
Syrasis, one of Ayicenna's expositors, also gives the rules of treatment with
great judgment.
Prosper Alpinus, gives a fair account of the ancient doctrines on this sub-
ject. Meth, Med. iv. 16. and de prcttag. vita et morte,\\. 21.
XXI. ON CONSTRICTION OP THE SKIN.
This chapter is taken from Oribasius, St/nops. v. 16. But a somewhat
fuller account is given by Galen. Hyg* iii* 10. Like our author, he states,
that this affection is occasioned, either by a collection of thick viscid humours
in the body, or by contraction, that is to say, spasm of the cutaneous pores.
It is generally brought on, he says, by exposure to cold, or going into an
astringent bath. He gives very minute directions about the treatment, re*
commending hot baths, and friction with oils of a calefacient and attenuant
nature. — See also Aetius,Iib. iv.46. and Actuarius, Meth. Med. iii. 16.
Avicenna treats of it in the same terms as Galen. Lib. i. fen. 3. doct.
3. c. 15.
XXII. — ON SPONTANBOUS LASSITUDE.
These judicious observations are taken from Oribasius, Sj/nops. v. 21 . —
See alsoGalenus, de sanitate tuenda, lib. iv. — Aetius, lib. iv. 41. — Avicenna,
lib. i. fen. S. doct. 3. c. 16. — Alsaharavius, Prac^ lib. xxxi. §. 2. c. 11.
Rhases, Contin. lib. xxxi. — ^Averrhoes, Colliget. vi. 14.
All the authorities recommend nearly the same methods of treatment. Ga-
len's account of the subject. is full, complete, and satisfactory; but so lengthy,
that I cannot venture even upon an abstract of it. He gives proper directions
for the physician to endeavour to find out the cause of the lassitude, and to
remedy it accordingly. It is often connected, he says, with retention of the
menstrual or hemorrhoidal evacuation, or the stoppage of some customary dis-
charge. When attended with inflammatory symptoms, he is, properly, very
urgent in recommending immediate venesection, without which, as be re*
marks, the patient cannot escape with his life, unless he is saved by a critical
evacuation, such as bleeding from the nose, or profuse sweating.
When in the inflammative lassitude, the head is affected, Aetius directs
to open the cephalic vein; when the chest or back, the basilic; and when
the whole body equally, the median. He recommends also, cooling herbs,
nich as beet, mallows, lettuce, and the like, with ptisan and tepid water.
He forbids the use of cold water. After the third day, if the patient is con-
valescent, he allows a thin weak wine, much diluted.
Averrhoes approves very much of Galen's directions respecting the treat-
ment, except that the peppers recommended by him had not been found to
answer in nis climate (Corbuda). Instead of them, he directs to give cinna^
mon, amber, cassia lignea, and similar aromatics.
Avicenna joins Galen in cautioning the physician to be guarded in allow-
ing his patient to take much food, as the vems being emptied by the remedies
applied for removing the lassitude, greedily absorb the chyle before it is pro-
perly concocted.
70 COMMENTARY ON THE FIRST BOOK.
XXIII. ON THE REGIMEN OF OLD PERSONS.
This chapter is copied from Oribasius, Synops. v, 18. — See also Aetias,
lib. iv. c. 30. These directions are all borrowed from Galen, {Hyg. lib. v.)
-who has treated of the subject with his characteristic elegance and good sense.^
The following is a brief exposition of his views of practice in such cases : —
<' Old age is cold and dry, and is to be corrected by diluents and calefa-
cients, such as hot baths of sweet waters, drinking wine^ and taking such food
as is moistening and calefacient/' He strenuously defends the practice of al-
lowing old persons to take wine. He properly expresses his disapprobation
of giving them aloetic pills to remove constipation of the bowels, and advises
rather to keep them open with laxative herbs and oily clysters, in the manner
stated by our author. Aetius remarks, in like manner, that old men are much
hurt by strong purgatives, which only increase the disposition lo costiveness.
All that is required m such cases, he remarks, i^ to lubricate the rectum with
an injection of oil. The Arabians follow closely in the same strain. Alsa-
haravius recommends old persons to drink strong diuretic wines. He also
approves of the tepid bath, and fiiction with emollient oils. He disapproves
of much exercise and of taking aloetic pills, instead of which, he directs to
give oily clysters and laxative herbs. — Pract. xxvii. 10. — See more particu-
larly Averrhoes's Commentary on the Cantka oi Avicenna, tr. i. They
agree^ that if an old man had been accustomed to be frequently bled, the
practice is not to be wholly laid aside. Avicenna particularly approves of a
milk diet. He recommends to drink old red wines, but to avoid such as are
new and sweet. Lib. I. fen. 3. doct. 3.
XXIV. ON RU008ITT OF THE SKIN.
This chapter is taken from Oribasius, Synops. v. 20.
XXV. — TO MAKE THE PERSPIRATION FRAGRANT.
This is copied from Oribasius, Synops. v. 21 . — See alsoRhases, ad Mansor.
V. 53. — Rhases recommends to take the heads of cardui for food, and the
seed of juniper or cassia lignea in the drink. He also directs to rub the
body with pastils of roses, and to drink aromatic wine.
XXVI. TO WARM THE HABIT.
All this chapter is taken from Oribasius, excepting the part relating to
the draught or propoma. The nature of the Propomata will be explained in
the 7th Book.
XXVII. ON LIVIDITY,
This is taken from Oribasius. Synops, v. 24.
XXVIII. PRESERVATIVES OF THE TEETH*
This chapter is mostly taken from Oribasius. Synop. v. 25,
COMMSNTARY ON THE FIRST BOOK. 7 1
Rhases gives similar directioDS. He recommends to avoid emetics, and
to pay attention to keeping them clean. He recommends the following
dentifrice : — Of hartshorn, of the seeds of tamarisk, of cypenis, of spiken-
ard, of each 3)9 of the salt of gem 3ij, to be pulverised, and the teeth rubbed
with it. Ad Mansor, iv. 21.
XXIX. ON PRB8BRVATIVBS FROM DBAFNB88.
This is taken from Oribasius. Synops. v. 23.
Rhases particularly directs to avoid indigestion, which, without doubt, is
occasionally the cause of indistinct hearing. He recommends to introduce
some almond oil into the meatus, and to guard against cold wind. Ad
Mamor. iii. 23.
XXX.— ^ON DIMNB88 OF 8IGHT.
This is copied firom Oribasius. Synopt. v. 27.
Rhases gives very copious and sensible directions on this subject, but
many of them are the same as those given by our author. He directs to
avoid all gross and diffusible articles of food, and also thick wines. Al-
though he forbids to read books written in small characters, he recommends
to exercise the eyes, by looking at large letters or pictures. He also recom-
mends various coilyria, containing antimony, tutty, calamine, camphor, and
the like. Ad Mansor, iv. 22.
XXXI. ON REPLETION OR PLETHORA.
Our author, as usual, copies from Oribasius. Synops. v. 28.
Hippocrates describes accurately the bad effects of plethora, but at so
great length, that I cannot venture to give an outline of his practice. I may
mention, however, that purging with hellebore, emetics, the warm bath, ana
venesection, are his most powerful remedies. De Diata. iii. 16. et seq.
Galen also has a treatise of considerable length on the same subject.
Among the causes of plethora enumerated by him, I remark, that he men-
tions the use of the warm bath after meals, whereby he holds that the system
is overloaded with imperfectly concocted chyle. De Plenitudine, if Meth,
Med,\TL. 5. — See also Rhases, ad Mansor, ii. — Haly Abbas, Prac^ i. 12. —
Alsaharavius. Pract. v. 4. — Averrhoes, Comment, in Cantic. Avicenna, —
Avicenna, lib. i. fen. 2. doct. 3.
Alsaharavius says, that plethora is marked by ruddiness of the body,
heaviness, torpor, large veins, somnolency, a large face, and brawny limbs.
U is usually accompanied, he adds, by impairment of the understanding,
forgetfiilness, heaviness of the head, weakness of sight, great pulsation
of the arteries, and a disposition to epistaxis. He directs to use a restricted
diet, consisting of articles not very nutritious, to take exercise, the bath, along
with friction, and medicines calculated to evacuate the prevailing humour,
whether blood, phlegm, or bile.
Haly's account is very like our author's.
Rhases gives a good description of repletion, which, he says, is ge-
nerally brought on by excess in eating and drinking, along with too much in-
dulgence in sleep. Avicenna's description is similar.
72 COMMENTARr ON THE FIRST BOOK.
XXXII. — ON INTOXICATION.
Th£S£ simple directions are extracted from Oribasius. Sj^nopsUf v. 33,
Hippocrates recommends an emetic after intoxication, de DicstUy iii. 4.
For the cure of intoxication, Haly Abbas recommends the tepid bath,
aflfusion of tepid water, and friction with oil. If headach prevails, he directs
to pour cold rose oil on the head ; or, if it is summer, cold water. After
ill is, the person is to be rubbed, and to take things of a cooling nature, such
as prunes, tamarinds, and the like. PracL i. 8.
Khases recommends vinegar and water, or the like, for drink ; to apply
vinegar and oil of roses to the head, and camphor and water to the nose.
He also approves of emetics, and of putting the person's hands and feet into
cold water. Ad Mansor. v. 72.
The practice of taking an emetic after a debauch, is often alluded to in the
works of the classical authors. Thus, it is mentioned by Aristophanes in bis
Acharnenses. Suetonius, in the lives of Vitellius and Claudius, states, that
these Emperors were in the practice of procuring vomiting, in order to re-
lieve themselves from the effects of excessive eating and drinking. — See also
Plin. H. A', xiv. §. 28.
XXXIII.— ON WRONG DIGESTION OF THE FOOD.
See Oribasius' Euporiitj i. 3, and Sj/nops. v 30. This subject will be
more fully treated of in the 3d Book.
XXXIV. — ON VENERYr
The contents of this chapter are mostly taken fvom a fuller account of
(his delicate subject, given in an extract from the works of Ruffus, preserved
by Oribasius. Med. Coil. vi. 38.— See also Aetius, iii. 18. and Galenus^
Ars. Medica. — Avicenna, Cantica. — Averrhoes, Comment, in Cantica, and
Colliget vi. 7. — Rhases, ad Mansor. iv. 17. — Haly Abbas, Prac^ i. 10. 13.
— Alsaharavius, Thcor. tr. x.
Averrhoes says, venery, in a word, induces the following evils : dryness of
the body, effeminacy, imbecility, exhaustion, and at the same time, prostra-
tion ; wherefore the friction which is had recourse to, after it, ought to remove
the inconveniences occasioned by it. This should be much and rough fric-
tion, and be performed with oil.
According to Avicenna, excessive indulgence breaks down the powers of
the constitution, and superinduces either a cold intemperament or hectic
fever. Abstinence, on the other hand, by those who had been in the habit
of indulgence, is said to bring on heaviness of the head, and diseases of the
joints and testicles. In this case, he recommends rue, and various other
articles, which were supposed by the ancients to be possessed of anti-aphro-
disiacal properties. Cicuta, according to Pliny, produces this eiect.
Alsaharavius forbids coition when the body is either reduced by absti-
nence, or overloaded with too much food and drink. The proper season for
it, he says, is after sleep, when digestion is accomplished, and towards morn-
ing. It is prejudicial, he says, in very hot seasons, and to persons of a
dry intemperament. Rhases, like our author, says, that moderate indulgence
removes plethora, lightens the mind, and cures sorrow.
According to Haly Abbas, the most proper time for enjoymenl is after
digestion, and when the food has descended from the stomach. If performed
COMMXNTART ON THX FIRST BOOK. 73
before sleep, he says, there is most chance of impregnation. Abstinence,
when one bad become habituated to the act, he says, weakens the natnral
heat, hurts the breast, stomach, and liyer, induces coldness of the body, and
renders it dry, sluggish, and enervated. Excess, on the other hand, brings on
premature old age, and consumption.
It will be remarked, that our author and Alsaharavius, differ in opinion as
to the best season for partaking of the dwp iparh xpv^f A<l>podtTrj£, Sanc-
torius, the great moaem anthority on this subject, agrees with the latter.
One of his aphorisms, is as follows : — '* Coition is injurious after exercise,
after meat not so much; but after sleep it is the most wholesome of all." —
Non nostrum inter eos tantas componere lites 1
See a learned disquisition on this and other similar matters in the Sj/wpo-
siacon of Plutarch.
As an apology for having ventured upon the discussion of this subject at
all, I beg leave to quote the following epigram, wherein, as will be re-
marked, ** Venus*' is mentioned as one of tne three grand causes which pro-
duce health and disease : —
** Balnea, Vina, Venus corrumpunt corpora Sana,
Corpora sana dabnnt Balnea, Vina, Venus.'*
XXXV. ON IMPOTSNCB.
AxHENiEUS mentions that it was a practice with some to put sponges into
beds, as incentives to venery. He states upon the authority of Theophrastus,
that certain medicines are possessed of aphrodisiacal properties, to an almost
incredible degree. Deipnos i. 15.
The ancients held, that most of the testacea are aphrodisiacal — See Plau-
tus, Casinoy Ac. ii. sc. 8. 1. 59. and the note of Lambinius. — Ed. Grononii,
also Petronius Arbiter, Satyricon.
The rocket (eruca) was particularly celebrated as an aphrodisiacal herb. —
See Pliny, Ji. N, xix. 8. and Juvenal, Sat, ix. 134. Columella, in Hori.
Galenus, defac. alim. lib. ii.
On this subject, see Rhases, ad Mansor. v. 62, Continens, lib. xxiv.
Avicenna, lib. iii. fen. 20. tr. 1. — Alsaharavius, Pract. xxii. 11. Rhases
gives a long list of articles which were supposed to be possessed of aphrodi-
siacal properties, such as nettle-seed, elecampane, rape-seed, mint, rocket,
cresses, &c. Avicenna's account, however, is the ftiUest. He directs to rub
into the parts liniments, containing stavesacre, pellitory, squills, myrrh, assa-
foetida, and the like.
XXXVI. ON INORDINATE YENSRT.
This chapter is partly taken from Oribasius, Synops, v. 35. A similar
account is given by Rhases, ad Mansor. v. 67. Inordinate venery, he says,
occasions premature old age, dries the body, and brings on frigidity. Conn
iinens, c. xxiv. — See in like manner, Avicenna, lib. iii. fen. 20. tr. 1 . c. 36.
To restore the body when debilitated by excessive enjoyment, he recom-
mends a cale£stcient and diluent regimen, nutritious food, baths, aromatics,
and everyt hing that can exhilarate.
Sanctorius on this subject holds, that '^ coition to excess does great harm,
by heating and drying the body." Medicina Statica, sect. vi. ap. 38.
74 COMMBNTART ON THE FIRST BOOK.
XXXVII. ON REDUNDANCE OF SEMEN.
This chapter is taken with a very few slight alterations, from Galen, de
sanitate tuend&y yi. 14. The same treatment is recommended by Avicenna,
lib. iii. fen. 20. tr. 1. c. 35. and by Rhases, ad Mantorem, v. 67. Alsaha-
ravius recommends bleeding, and various cooling and astringent remedies,
both internally and externally. Pract, xxii. 9.
Hippocrates says, that the strychnos cuies impure dreams. De Diaia,
lib. ii. Serapion states, that the lettuce possesses '< virtus contraria sper-
mati.'' De simpL ex plantU,
We may remark here, once for all, that by the juice (xvXog) of herbs, the
Greek medical authors generally mean the decoction. Thus, according to
Dr. Coray, by ^vXor tS>v €p€piv6&v, Hippocrates undei'stood d(f)€yln]fia r. c.
Xenocrat, etjGalen ex aquat. p. 219 ; and, in like manner, as Le Clerc re-
marks, by x^\os TrTKTajnjs, was meant strained ptisan. Hist, de la Med,
XXXVIII. ON PERSONS WHO Hi^YB SUFFERED FROM COLD.
This chapter is taken from Oribasius, Sj/nops. v. 36.
Rhases directs to lay a person congealed with cold in a warm apartment,
and to rub with hot hands the whole of his body, with the exception of the
bead, which is to be warmed with hot cloths. Persons having warm bodies
are then to lie down in bed beside him ; and he is to take a draught con-
taining assafcetida, myrrh, pepper, and strong wine. When the respiration
is fairly restored, he is to take some nourishing food and wine ; and is then
to be covered up with many blankets and left to sleep. When he awakes,
he is to be put into a hot bath, and after remaining for a long time in it, he is
to be strongly rubbed when he leaves it with cale^ient oil, such as the oil of
lilies or narcissus, to which costus, castor, musk, and spurge have beeil ad-
ded. Ad Mansor. vi. 5.
Let the reader remark the similarity of the ancient practice in the cases of
persons who have been exposed to great cold, and of those who have been
poisoned with opium. — See Book v. c. 43. Galen remarks, that the effects
of opium and of the exposure of the body to extreme cold are very like
Comment, in Epidem.
In the 4th book of Xenophon's Anabasis, there is an interesting description
of the effects resulting from the exposure of the Grecian army to extreme
cold, and the means which they took to preserve themselves from being in-
jured by it. The historian relates, that they rubbed themselves before the
fire with an ointment composed of swines' seam, and oils of sesame, of bit-
ter almonds, and of turpentine. The Carthaginian soldiers of Hannibal, in
like manner, when exposed to great cold among the mountains of Italy, rub-
bed their bodies with oil as a protection from its effects, and with great suc-
cess, if we may believe Florus the historian- He says, *^ tunc callidissimi
hostes frigid um et nivalem nacti diem, quum se ignibus prius, oleoque fo vis-
sent (horribile dicta!) homines a meridie, et sole venientes, nostra nos hieme
vicerunt.^' Hist. Rom. ii. 6. — It is worthy of remark by the way, that Baron
Larrey, in his account of the retreat of the French army from Moscow, states,
that the inhabitants of southern climates endured the cold better than those
of the north. The fact, that the Carthaginian soldiers rubbed their bodies
with oil on the occasion we have mentioned, is stated also by Polybius, Hist.
iii. 72. and by Livy, Hist. Roman, xxi. 55.
Quintus Curtius relates, that the soldiers of Alexander the Great, rubbed
COMMJBNTMIT ON THX FIRST BOOK. 75
their bodies with the juice of sesame, instead of oil, when eiposed to intense
cold while crossing the Bactrian mountains. Lib. vii. c. 15.
Pliny, with his usual terseness, thus states the powers of oil in protecting
the body both from cold and heat : <* Oleo natura tepefacere corpus, et
contra algores munire : eidemque fervores capitis refrigerare.'' U, N, xv. 6.
XXXIX. — FOR FBR80N8 WHO HAVB 8UFFBRXD BT BXFOSURB TO
BXCBSSIYB HBAT.
This chapter is taken from Oribasius, Synopx. v. 37.
When a person has suffered from exposure to great heat, Rhases recom-
mends rest, the tepid bath, and fruits and food of a cooling and moistening
nature. When there is headach, he directs to anoint the head with oil of
roses and vinegar. Ad Maruor. vi. i.
Averrhoes recommends when a person has suffered from exposure to the
sun, to put him into a tepid bath, and rub him afterwards with refrigerant
oils. Collect. § iii. c. 9.
XL. ON COLLBCTIONS OF PHLBOK IN THB STOMACH.
This chapter is taken from Oribasius, who, in his turn, is indebted to
Galen.
A similar account of the matter is given by Rhases, Contineru, xi. tr. 1. —
He recommends emetics, Ad Maruor, iv. 16.
XLI. HOW TO PRODUCB BAST VOMITING.
This ehapt^ is abridged from Oribasius, Med. Collect, viii. 21. — ^The
opinions of Gralen, Diocles, and Archigenes, on this subject, may likewise
be learned from Oribasius. Galen recommends vomiting for collections of
yellow bile, and when the stomach is loaded with viscid matters, but forbids
it when the stomach is weak. The opinions of Celsus are very similar :
** Vomitus ut in secunda quoque valetudine ssepe necessarius biliosis est, sic
etiam in iis morbis qnos bilis concitavit. — ^Vomitus utilior est hieme quam
aestate ; nam tum est pituits plus, et capitis gravitas major subest. Inutilis
est gracilibus et imbecillum stomachum habentibus: utilis est plenis et
biliosis omnibus si vel nimium se replerunt, vel parum concoxerunt.'' These
rules of Celsus are approved of by Dr. Pemberton, on Abdominal Diseases.
—The directions given by Celsus for producing vomiting are very simple ;
^ Qui vomere post cibum volet, si ex facili facit, aquam tantum tepidam
ant^ debet assnmere : si difficiliils, aquae, vel salis, vel mellis paulum adjicere.
At qui mane vomiturus est, ant^ bibere mulsum, vel hyssopum, aut esse 1^-
diculam debet, deinde aquam tepidam (ut supra scriptum est) bibere.'' —
Galen commends the bulb pf the narcissus as an emetic. He forbids those
who have contracted chests to take emetics frequently. De Furgantibus
Medkinis.
Aetius gives an interesting account of this subject in an extract from the
works of Rufius. He forbids to excite vomiting when the eyes are affected,
or when haemoptysis is apprehended. He commends it for the cure of arth-
ritic diseases, dropsy, and jaundice. One of his simplest emetics consists of
the decoction of radishes, with the strained infusion of dried figs. He men-
tions the oil of Privet as a most effectual emetic. Lib. iii. c. 19.
Avicenha*s information on this subject is very ample ; but, upon the whole.
76 COMMBNTART ON THB PIRST BOOK.
his directions are mostly the same as our author's. He properly states, that
the too frec|uent repetition of emetics hurts the stomach, is prejudicial to the
chest, the sight, the teeth, in chronic pains of the head, unless arising from
sympathy with the stomach ; and in epilepsy, when the cause of it is seated
in tne head. Lib. i. fen. 4. — According to Avicenna and Averrhoes, the
proper season for emetics is the summer. Cant, p. i. tr. 1 .
llhases says, that much vomiting hurts the liver, breast, eyes, and lungs,
occasioning haemoptysis. He directs to bind a compress on the forehead
before taking an emetic ; and to wash the mouth and face with hydromel
after its operation. He adds, that persons who have long necks, prominent
chests, and who are lean, ought to abstain altogether from emetics. Ad
Mansor. iv. 16.
Haly Abbas forbids emetics in chronic complaints of the head and chest,
especially if the person be threatened with Phthisis. He says, that the repe-
tition of them weakens the stomach, and may induce haemoptysis. Pract. i.
12, 13. Alsaharavius delivers exactly the same detail of the cases in which
emetics prove hurtful or beneficial. Theor. x. 2.
Serapion gives a full account of these gentle emetics, De Antidotis, c. 36.
On the simpler methods which the ancients had recourse to in order to
produce vomiting ; see Prosper Alpinus, Med. Meth. iii. 1 0.
Dr. Paris says, '* The predilection of the ancients for emetics is the more
extraordinary, as they were acquainted with those only which were of the
most violent and unmanageable description ; the veratrum or white helle-
bore, was sometimes fatal.'' Pharmacologiay vol. i. It is certain, however,
that the ancients did not use the more violent emetics on ordinary occasions,
nor unless when it was found very difficult to produce vomiting. The learn-
ed Andreas Laurentius, physician to Henry the IV. of France, gives the fol-
lowing account of the ancient method of vomiting, which, it would appear,
was still practised in his time : '' Grsecis vomitus ante pastum matutini et
jejuui (Tvpfuutrfioi dicti, commendabantur. Quibus igitur hoc pacto vomere
pfacuerit, radiculas tenues, nasturtium, erucam, portulacam devorent, deinde
aqua tepida affatim hausta vomant. Veteres utebantur aqua mulsa mera-
ciore, succo ptisans ex aqua per se, vel cum melle decocto, et iis efficaciori-
bus surculis veratri albi in rafanum defixis, vel rafiwis solis postero die ex
aceto mulso comestis.*' De Strum. Nat. p. 274. I have been informed,
that several of the bulbous roots were formerly used in Scotland as domestic
remedies for producing vomiting.
XLII.-— ON LAXATIYBS AND DIURBTICS TO PBRSONS IN HBALTH.
ORiDAsr US treats fully of purgatives towards the end of the 8th Book of
Med, Collect. He gives a list of gentle laxatives. Euporist, i. 45.
Hippocrates frequently recommends gentle purgatives for the preservation
of the health. Of this class, the herb mercury appears to have been his fa-
vourite.
Galen has given two distinct treatises on purgatives, and the cases in whidi
tliey are applicable. He dissuades those who are in perfect good health
from taking them, but says that they may often be used so as to prevent the
recurrence of diseases. Hence, he says, that he had of^en prevented gout
and rheumatism from relapsing, by the seasonable administration of purga-
tives. He forbids purgatives when the hypochondria are distended with fla-
tulence.
Aetius gives a veiy lengthy account of the preparation of purgative me-
dicines, which, however, will be noticed more properly in the Seventh Book.
— He states, that all medicines of a cutting or penetrative nature are diuretic.
COMMSNTART ON THE FIRST BOOK. 77
He mentions plantain, fennel, parsley, beseli, anise, valerian, bitter al-
monds, &c. Lib. iii.
Celsus gives the following list of gentle diuretics : ** Urinam movent, quae-
cunque in horto uascentia boni odoris sunt, ut apiuro, ruta, anethum, ocimum,
mentha, hyssopum, anisum, coriandruro, nasturtium, eruca, feniculum:
prster h«c, asparagus, capparis, nepeta, thymum,satureia,lapsana, pastinaca,
magisque agrestis, radicula,siser, cepa; ex venatione, maxim^ lepus ; vinum
tenue, piper et rotundum et longum, sinapi, absinthium, nuclei pinei.'' — He
also gives a long list of laxative articles, such as cabbage, mallows, sorrel,
gourds, cherries, all ripe apples, green 6g8, cockles, oysters, muscles, milk,
crude honey, and all tatty and saltish substances. Lib. ii. 29. Horace
makes mention of the laxative properties of muscles, shell-Bsh, dock, and
white wine :
Si dura morabitur alvns,
Mitolus et viles peUent obstantia conchse,
Et lapaihi brevis herba ; sed albo non sine Coo.^ — Sat, ii. 4.
Avicenna gives very minute directions respecting the use of purgatives.
He very properly recommends when a purgative medicine has been taken,
and instead of operating, has occasioned heat, vertigo, and headach, to admi-
nister an injection. Lib. i. f. 4.
Haly Abbas treats of these medicines in pretty much the same terms as
our author. He remarks, that obstruction of the bowels leads to colic, flatu-
lence, difficult respiration, and vertigo. Retention of urine, he says, leads to
ulcers in the bladder. He states, that diuretics are useful in diseases of the
joints and spine, dropsy, and various complaints, but are apt to render the
body dry. Tract, Lib. i. 12. Diuretic medicines, he remarks in another
place, are of a hot and sharp nature, so that they heat the kidneys, and there-
by increase their attractive power. Lib. ii. c. 27.
Alsaharavius cautions against the indiscriminate use of purgatives, which,
he says, in a dry temperament disposes to phthisis, and to dropsy when the
stomach is weak. When a purgative medicine has induced hypercatharsis,
he directs to take astringent powders, containing sumach, pomegranate, and
the like. Theor.n.l,
Rhases gives some very sensible observations on the use and abuse of pur-
gatives. He says, that persons who lead an indolent life, are of a gross
habit, and live freely, are most benefited by them. To those of a dry tem-
perament, on the other hand, they prove prejudicial, by pre-disposing to hectic
fever. He recommends to eat fat food, and to go into the warm bath before
taking a purgative. — Ad, Mansor, Lib. iv. c. 15.
See a full account of these laxative medicines in Serapion de Antidotis,
XLIIL ON CLYSTERS.
Hippocrates frequently recommends the administration of clysters. He-
rodotus mentions, that the ancient Egyptians had recourse to clysters at
stated periods every month. Lib. ii. c. 77.
Oribasius has treated of the composition of clysters, and the cases in which
they are to be applied so fully in the Eighth Book of his Medica Collectanea,
that he may be said to have exhausted the subject. It appears from his ac-
count, that the ancients used a syringe for throwing up injections. A large
clyster, he says, amounts to three heminse, a small one to one hemina, and a
moderate one to two hemins. Si/nop, i. 19.
Celsus, after some very appropriate observations on the cases which are
benefited by clysters, concludes with the following directions for the compo-
Jition of them: — plain water may be injected, if the case be slight; or honied
78 COMMENTARY ON THE FIRST BOOK.
water, if stronger means be required ; if emollients be indicated; the decoc-
tion of mallows, of fenugreek, or ptisan may be used ; or if astringents be pro-
per, vervain. Acrid clysters may be formed of sea-water, or with the
addition of some salt, and their strength may be increased by boiling. Such
a clyster may be rendered still more acrid by the addition of oil, nitre, or
honey. He remarks, that the more acrid a clyster is, the greater will be its
purgative effect, but the more difficult will it be to bear. He says it ought
to be neither hot nor cold. After the injection has been thrown up, he re-
commends the person to remain quiet, and to resist the first desire to go to
stool. Lib. ii. c. 12.
Aetius treats of clysters very fully. He prefaces his account of the mode
of administering them, with a correct detail of the evils arising from consti-
pation, which, he justly remarks, is the precursor of most of the ills which
break out in the human frame. Lib. iii. 159.
See a long list of prescriptions for Clysters in Serapion, de AntidotiSy tr.
vii. 26. Rhases and Avicenna give a full account of the nature of clysters,
but supply no additional information on the subject.
XLIV. ON SUPPOSITORIES.
This chapter is entirely taken from Oribasius, Si/nop. i. 20. See a fuller
account in his Med, Collect, viii. 39. and Aetius iii. t60. Aetius, after
mentioning the composition of certain suppositories similar to those of our
author, speaks also of using for this purpose, figs mixed with nitre (soda ?)
and grapes deprived of their stones, with the addition of nitre and cumin.
Actuarius states, that it is when the obstruction is seated in the rectum
that suppositories are particularly applicable. Meth. Med, iii. 5.
See also Avicenna. Lib. iii. Fen. 20. tr. 1. and Rhases, Continens,
Lib. xxiv.
XLV. ON MEDICINES WHICH EVACUATE THE HEAD ON MASTICA-
TORIES, SRRHINES, AND LINIMENTS TO THE NOSE.
This chapter is taken from Oribasius, Si/ nop, i. 21.
Hippocrates makes frequent mention of the caput-purgiOf or medicines
which purge the head. On the composition of thes^ medicines, see in par-
ticular Aetius iii. 140, 141. — Nonnus, Epitome c. 17. and Serapion, de
Antidotis, Lib. vii. c. 31. They contain such articles as these: pepper,
nitre, white hellebore, spurge, gith, pellitory, mastich, turpentine, mustard,
chalcitis, alum, and the like. The errhines were used principally in obstruc-
tions of the nose, and when the sense of smell was impaired. The opo-
phlegmatismi were supposed to prove useful in chronic affections of the head,
impairment of the senses of smell and sight, and also when the tongue and
throat were affected.
Prosper Alpinus gives a full account of the errhines, masticatories, and
cough medicines of the ancients. Med. Meth, iii. 11. He makes the caput-
purgia to be the same as the errhines, and the apophlegmatismi the same
as the masticatories of the moderns.
XLVL — ON BMMBNAGOGUBS.
This chapter is taken from Oribasius, Synopi, i. 22. A fuller list of the
medicinal articles which were supposed by the ancients to promote the men-
COMMBNTART ON THE FIRST BOOK. 79
struS discharge, is given by Aetius. Lib. iii. 153, 154. It contains cassia,
myrrh, thyme, centaury, wormf^ood, nettle, elaterium, black hellebore, tur-
pentine-rosin, cumin, sage, and the like. All these were used in injections
and suppositories. The following were given by the mouth, and were held
to be likewise diuretic : hedge-mustard, rue, marjoram, southernwood, saga-
pene, galbanum, spikenard, the herb mercury, savin, iris, birthwort, &c. See
Albengnefit, LibcUus,
Dioscorides is censured by Dr. Cullen as being too credulous in assign-
iag fmmenagogue properties to a variety of articles in the Materia Medica.
Perhaps, however, there is some foundation for the doctrine of the ancients,
that all hot diuretic medicines are in so far emmenagogue. Prosper Al-
pinus maintains this opinion, but remarks, that the action of the emmena-
gogues is more uncertain than that of the diuretics, and must be assisted by
warm baths, pessaries, and fomentations. We will have occasion to treat
more fully of these medicines in the Third Book.
XLVIL— ON suDORirics.
This chapter is mostly copied from Oribasius, Synops. i. 23. Aetius enu-
merates a good many more medicines of this class. Of these some are to be
taken by the mouth, as cumin, bay berries, cyrenaic juice, castor, and lovage ;
some are to be rubbed into the skin, as nitre with oil, the oil of dill, of cha-
momile, of bays, and of radishes ; and some are to be used in fumigations,
as pennyroyal, the seed of balsam, and so forth. He recommends these
medicines in jaundice, and for coldness and constriction of the skin. Aetius,
Lib. iii. c. 157.
Celsus treats of the methods for producing free perspiration with more than
his usual minuteness. Sweating, ne says, may be produced either by dry
heat, or by baths. The modes of applying dry heat, which he mentions, are
by heated sand, the Laconicum or Sweating apartment of the ancient bath,
^e chap. 51 .) the Clibanus or moveable furnace, and the vapour baths of
Bais. To these he adds strong exercise. He also treats minutely of the ap-
plication of baths and fomentations for the cure of diseases. Lib. ii. c. 17.
Consult Stobeeus, c. 100.
Haly Abbas directs to restore the perspiration, when stopt, by exercise,
friction, baths, and the affusion of hot water over the body. He recommends
to perform friction with the oil of violets, and such things as are mentioned
by our author. Tract, i. 12.
Khases recommends internally, castor, opoponax, or opium mixed with
honey, and given in tepid water. Externally, he recommends friction, with
the oil of chamomile, of pelUtory, or the like. Continens, lib. xxxi. Mesne
mentions fumigations with calamint, cinquefoil, carpobalsam, and bdellium.
Albengnefit 'recommends the same, and also friction with calefacient oils,
and the internal administration of cumin, calamint, and the like.
The ancients, as Prosper Alpinus remarks, seem to have trusted more in
external than in internal means for producing free perspiration. They were
aware, that when the system is greatly over-heated, a draught of cold water
by reducing the temperature of the body may prove sudorific. This fact is
distinctly stated ' by Galen ; and in accordance with this principle, Rhases
directs to give cold water in the hot stage of the small-pox, to facilitate the
eniption of the pustules. The reader will find a similar view of the matter
stated in Dr. Currie's Medical Reports.
On the sudatoria or vapour baths of the ancients, see Baccius, dc Thermis,
lib. iv. Horace thus alludes to the vapour baths at Baise :
'^ Sane myrteta relinqui,
Dictaqne cessantem nerris eudere morbum
Sulphura contemni viciis gemit.'' — Epist, i. 15.
80 COMMBNTART ON THE FIRST BOOK.
Upon which SanadoD remarks : " By sulphur a, the poet means tlie Aves,
where sulphureous vapours exhaling from the earth cause a dry beat, which
provokes sweat."
XLVIII. ON AIRS.
The first part of this chapter is taken from Oribasius, Synopi, i. 24. The
remaining part will be found in the Med, Collect, ix. 1. — where the subject
is treated of at great length. — See in like manner, Aetius, iii. 162. All
these authors, however, are much indebted to Galen, de sanitate tuenda, lib.i.
According to Galen, the moon produces changes in the atmosphere, whereby
she occasions putrefaction of dead bodies, impairs the colour, and hurts the
head of living persons. De Diebus Criticts, lib. iii. On the supposed
causes why the moon occasions putrefaction, see Plutarch, Sympos, lib. iii.
Antyllus says, that there are many differences of airs; some arising from
the season of the year ; some from the changes of the moon ; . and some from
the hour of the day or night; some from thickness or tenuity, motion or rest,
or from the admixture of terrene exhalations. The sun, he adds, warms the
body ; but the moon rather humectates, and, therefore, she moistens the
brain, and occasions the putrefaction of the flesh; renders the bodies of those
who sleep in the open air more humid and obtuse; and, for the same cause,
she induces epilepsy and heaviness of the head. Cold air, he says, produces
plumpness, good nutrition, and the formation of fat; it promotes the growth
of the body, and hence, the inhabitants of northern climates are remarked to
possess this character. It is unsuitable, however, to all acute disorders ; and
18 also improper for certain chronic diseases, such as consumption, cachexy,
paralysis, apoplexy, and rheumatism. But warm air consumes the body,
attenuating and wasting the system, but it is preferable to cold air for im-
parting vigour and agility; it tries the powers, and is useful in affections of
the nerves and chest, but not in those of^ other parts. Thick air has no other
good property, except that it prevents the powers from being dissipated.
Thin air is most conducive to health. The air of high situations, is said by
him, to be more salubrious to all except persons labouring under diaphoresis
or syncope, and the aged. The atmosphere of places near the sea, he re-
marks, is milder than that of inland parts. Places in the neighbourhood of
marshes are at all times unhealthy ; but, in summer, their atmosphere is pes-
tilent. Those by a river side are cold and changeable. — See more fully Sto-
baeus, Sermo, xcix.
Hippocrates gives many interesting observations on the effect of climate,
and the state of the atmosphere, in influencing the health, but they are de-
livered so much in detail, that my limits do not admit of my entering into an
exposition of them. De Aeribus, aquis, locis.
Haly Abbas gives a very elaborate disquisition on this subject. He de-
scribes minutely the characters of salubrious airs, and the changes produced
upon them by the seasons of the year, the state of the winds, the nature of
countries, and the stars, that is to say, the sun and dog-star. Theorictty lib.
V. — See also Rhases, Continens, lib. xxxiii. — Avicenna, lib. i. fen. 2. doct. 2.
XLIX. ON WATERS.
Our author has given an outline of Hippocrates' opinions on this subject,
and for fuller information, I must refer to the works quoted in the preceding
chapter.
The characters of the different kinds of water, are thus given by Celsus
COMMBNTART ON THB FIRST BOOK. 81
with his usual terseness: ''Aqua levissima pluvialis est: deinde fontana;
torn exflumine, turn ex puteo; post hsc ex uive, aut glacie; gravior his
exlacu; gravissima ex palude/' Lib. ii. 18. Their characters are some-
nvhat differently given by Athensus. Thus, he states, that water from snow
or ice is lighter and better than rain water; otherwise his remarks on the
qualities of waters are very interesting. He directs to take a moderate draught
of water at the commencement of a feast, in order that the veins, being in so
hr filled by it, may not greedily absorb the chyle before it is properly con-
cocted.— See DeipnosophUta, lib. ii.
Our author's account is abridged from Galen and Oribasius, Collect. Med,
lib. X. or rather is copied entire from Euporist. i. 14. Aetius gives a full
account extracted from Ruffus, lib. iii. 165.
Haly Abbas treats of this subject at great length. His characters of the
different kinds of water agree very well with those given by our author. He
states that rain water is the purest, and snow water the most impure. Haly
AbbaSy like our Mr. Abernethy, condemns the indulgence in a copious
draught after a meal. The reasons he assigns for its proving injurious are,
that it prevents the surface of the stomach from coming into proper contact
with the food, and also that it reduces the natural temperature of the stomach.
He recommends, if thirst be urgent, to allay it by drinking a small quantity
slowly. Theories, v. 29.
Alsaharavius advocates similar views. He also forbids to drink during
the night, as the sensation of thirst may be fallacious ; and at all events, he
says, it is only increased by indulgence. Theor, xiii. 1, and xii. 2.
Rhases^in like manner states, that a draught of water immediately after
eating impairs digestion, but is proper after digestion has taken place.
Continens^ lib. xxxiii. (Upon this principle we may see the propriety of
not taking tea until a few hours after dinner.) Rhases, in another place,
states that ice is prejudicial to the health, especially of old persons, by con-
gealing the stomach and hurting the nerves. He admits, however, of the
use of water cooled in snow, but recommends to counteract its effects by a
moderate allowance of wine. Water which has been drawn from a very
deep well he directs to boil before using it. Lib. xxxvii. tr. i. 70.
"nie following are the principal beverages of the Greeks and Romans :
Wine diluted with water; Mulsum, or a composition of honey and wine,
resembling the modem clary ; Hydromel, or honied water ; Zythi, or various
kinds of ales ; the Spathites, a wine prepared from palms, mentioned by our
author, lib. iii. c. 39 ; the Sicera, or cider prepared from apples; Perry, pre-
pared from pears ; Posca or oxycrate, a mixture of vinegar and water ; the
Cyceon, a mixture of wine, honey, flour, and water, according to Hesychius;
the Dodra of the Romans, very like the cyceon ; Ptisan, prepared from
polenta ; Barley water, mentioned by Hippocrates, de Morh. Acut. and well
described by the Arabians.
LI. — ON BATHS.
It is to be recollected that the baths of the ancients contained three dis>
tinct apartments. The construction of them is thus described by Wouwer in
anote on Plautus, Act i. sc. 2. 1. 1 : "Tres eedes seu cellae inbalneis. Prima
est CaldariCf ro Acuc&pueoPf Dioni nvpunmipiop, Senecse Sudatorium, nam
sicco calore sudorem in eo eliciebant. Secunda est media, quae et Tepidaria.
Tertia est Frigidaria.** Ed, Gronov,
Hippocrates thus explains his views of the effects produced by baths: The
hath or sweet water humectates and cools, for it imparts moisture to the
l»dy. The salt bath is calefocient and disiccative; for, being naturally hot, it
Q
82 COMMBNTART ON THE FIRST BOOK.
attracts moisture from the body. Wben the body is fasting the hot bath
is attenuant and refrigerant ; for by its heat it attracts the moisture from the
body, and when the flesh is deprived of moisture the body is cooled. But
after a meal it heats and humectates, by expanding to a greater bulk whaU
ever predominates in the body. The cold bafiis produce the contrary
effects ; for when the body is fasting they impart heat and moisture to it, and
after a meal they abstract moisture, and being cold they fill it with dryness.
Unction with oil is calefacient, moistening, and emollient. De Diata, ii. 36.
In another place, he states that the warm bath in moderation softens aqd
enlarges the body ; but when taken immoderately it humectates dry bodies,
and dries humid bodies. De AffectionibuSf c. 47.
Celsus gives some ingenious reflections on the effects of the bath^ espe-
cially in fever. He thus states the purposes for which it is applied : '' Fere
adhibetur, ubi summam cutem relaxari, evocarique corruptum humorem, et
habitum corporis mutari expedit.'' He recommends friction with oil before
going into the bath. Lib. ii. c. 17.
Psellus says that the warm bath relaxes, softens, and induces sleep, oc*
casioning plumpness of the body. Opus Medicum.
Our author copies from Oribasius, Euporist. i. 16. — See a fuller account
in Med, Collect, lib. x. Galenus, de Sanitate Tuerida, Aetius, iii. 169, and
Avicenna, lib. i. fen. 3. d. 2. Galen particularly recommends the cold bath
to persons in the prime of life, and during the summer season. Before
going into the bath he directs to get well rubbed first with rough towels and
then with oil. He recommends to plunge into the water at once and not
descend gradually. After coming out of the water he directs to get rubbed
with oil until the skin is warmed. Agathinus forbids to bathe in&nts in cold
water, but recommends the warm bath for them. Oribasius, ii. 7.
The ancients used baths medicated with mallows, linseed, or fenugreek,
when they wished to make tliem particularly emollient; and with roses,
pomegranate rind, or plantain, when they intended to render them astrin-
gent. Oribasius, u, «. They prepared hip baths also in this manner.—
Aetius, u, s,
Galen and Aetius direct to form the bath of oil by adding the fifth-part of
heated oil to a bath of water. They recommend it in protracted fevers at-
tended with chilis, convulsions, retention of urine, and to relieve lassitude
and nervous pains. The learned Bernard remarks, that it roust have been
the expense with which it is attended that has led to the disuse of the bath
of oil. Ap. Nonni Epitom. Avicenna and his expositor, Grentilis Fulginas,
particularly commend it for retention of urine. Mengus Faventinas pro-
nounces it to be highly anodyne.
Actuarius forbids the use of the bath to those whose systems are loaded
with superfluities and bad humours. De Diata, c. xi. Averrhoes lays down
the same prohibition. Collectan. ii. 4.
The proper time for the bath, according to Haly Abbas, is after exercise
and before eating. If used before exercise, it proves injurious, by occasion-
ing the distribution of any superfluities which may be remaining indigested
in the body, and determining them to improper parts. If used immediately
after a meal, he says, it proves hurtful, by promoting the absorption of un-
concocted chyle, and sending humours to the head. But, if used after exercise
and before a meal, it moistens the body, strengthens the vital heat, promotes
digestion, opens the pores, mitigates pain, and dispels flatulence. He adds,
a short continuance in the bath warms and moistens the body, but a long
warms and dries it. Theor, v. 13. In another place he says, that the proper
time for the bath is after exercise, vet not immediately, nor until the powers
of the system are in so far recruited ; but the body is to be first rubbed with
oil, and then the bath is to be taken, Pract, i. 5.
COMMBNTAKT ON THE VIRST BOOK. 83
The uses of the bath, according to Alsaharavius, are, to moisten the body,
open the pores^ dispel flatalence, remove repletion, procure sleep, relieve
pidnsy fluxes of the bowels, and lassitude, to restore lean bodies to plump-
ness and obesity if used after a full diet, to soften contracted limbs, moisten
dry bodies, and dry humid. The evil effects of it when misapplied are pros-
tiation of the vital powers, syncope, and determining the humours to weak
parts. TAeor. xi.l.
Aselepiades, a celebrated physician in the time of Pompey the Great, was
a distinguished advocate for the use of the bath. — See Plinius, H, N. xxxvi.
3. Celsas, ii. 6. Apnleius, Florid, c. 4.
Mercurialis gives an excellent account of the public baths of the Romans, de
Arte Oymnastka, i. 10*— On the construction of them, see Vitruvius, Arch.
V. 10. But for a full account of every thing relating to baths, see Auctores de
Balnets, Venet. 1553, and Baccins de ThermU^ Roma, 1 622. Baccius thus enu-
merates the general effects of the warm bath : ** Humectat in primis, et calefkcit
Uandissim^ : mox aperit, lenit, attenuat, digerit, revellit, maxim^ calidius.
Deinde urinas ac alvum ciet, sudores ac habitus insensibi les excitat. Dolores
mitigat, somnum conciliat, bonas concoctiones molitur, ac vires corroborat.*'
LIL— ON THB NATURAL BATHS.
This chapter is taken from Oribasius, Synops. i. 29. A fuller account is
given in ^ Medka CoUectaneOy x. 3. «^ uq. See further Aetius, iii. 167.
Haly Abbas, TAror. v. 13. Rhases, Conhneiif, lib. xxxvii. Avicenna, lib.
ii. tr. 2. c. 15.
Pliny enumerates ftilly the good effects of the natural baths at Baiae,
fl. N. xxxi. 2.
Aetius' account is borrowed from Archigenes, and is much the same as
our author's. He recommends the sulphureous bath for the cure of alphos
and nielas, leprosy, scabies, impetigo, old ulcers, scirrhus of the liver, spleen
and utems, paralysis, arthritic diseases, and prurigo. Rhases and Avicenna
also recommend it in these complaints.
The principal natural baths, as they are called, are those impregnated
with sulphur, alum, soda, saltpetre, iron, or copper. Baccius also makes
mention of water impregnated with lead, mercury, bitumen, antimony, and
arsenic. His directions for the use of them are most important, but unfor-
tanatriy tay limits will not permit me to do justice to them.
Georgios Agricola particularly commends the sulphureous bath for the
care of arthritic diseases.
LIII.— ^N T&K EBOIMBN BBFITTINO THB DIFFBRENT SBASONS.
Tsii ig copied from Oribasius, Euporist. i. 10.
It is one of the Aphorisms of Hippocrates, that those who require blood-let-
ting or medicine should be bled or take medicine in the spring. Aphor. sect,
vi. Galen, Rhases, Haly Abbas, and in short all the ancient authorities
agree with bim respecting this rule of practice, which is still frequently fol-
lowed by the common people in Scotland. According to Alsabaravius, the
palte is stronger and foller in spring than at any other season. Theor. vii. 2.
Hippocrates and Gralen linr it dovm as a general rule that the fullest diet
is most proper in vrinter, and the sparest in summer. Aphor, i. 18.
Rhaiei lays down very suitable directions for the regimen that is most
proper during every season of the year, but they are scarcely at all different
rat our authoi^s. As we have mentioned, he recommends depletion in
62
I
84 COMMENTA.RY ON TH£ FIRST BOOK.
•
spring before the heat set in. In sununer, he approves of cooling acid fruits
with cold water for drink. In autumn, he directs to abstain from cold baths
and to use a restricted regimen. In winter, he recommends a full propor-
tion of calefacients, such as pepper, cumin, mustard, and rocket. Ad, Man-
$or. iv. 26. Winter, he says in another work, favours the formation of flesh
and blood, braces the body, and strengthens the powers. Spring fills the
system with humours. Summer dissolves the humours, and weakens the
internal powers. Autumn engenders bad humours, bile, and blood. Contij
nensy lib. xxxiv.
Haly Abbas recommends purging or bleeding in spring, to evacuate the
superfluities formed and shut up in the system during winter. In summer,
the regimen is to be cooling and diluent, little exercise is to be taken, the
cold bath is to be used, swimming in cold water is to be practised ; for food,
chickens, flsh caught among rocks, grapes, apples, and the summer fruits,
will be proper; but wine is either not to be drunk at all, or much diluted
with water and cooled in snow ; and venery is to be avoided. In autumn,
the regimen is to be cooling and disiccative, the exercise moderate, the cold
bath is to be avoided but the tepid is to be taken, and much fruit is to be
avoided. In winter, the regimen is to be heating and disiccative, and wine
is to be taken moderately. The wine, he adds, ought to be strong and
heating, to counteract the cold of winter; but much must not be taken, be-
cause it will dilute and humectate the body which stands in need of disicca-
tion. Wine, too, he says, possesses little nourishment, whereas the system
requires much support in winter. He recommends the flesh of quadrupeds
and fowls for food. Fracticay lib. i. See, in like manners Avicenna, lib. i.
fen. 3. div. 5. Alsaliaravius, Theor. ix. 2.
The poet Ilesiod recommends a full diet in winter. Opera et Dies,
I. .558.
Maximus Planudes, in a declamation in praise of winter, aflirms that at
this season the heat, being confined within the body, operates more strongly
in performing the vital functions than at any other season. This season, he
says, is favourable to all classes of men except doctors ; but they are sick at
heart to see that no other persons are sick, and, bewailing their own misery,
undergo the thirst of Tantalus amidst the rains of winter ! V. Boissonade,
Anecdota Graca, vol. ii.
LIV. ON THB REGIMEN OF PERSONS EMPLOYED IN BUSINESS.
Thi3 is taken from Oribasius, Si/nops. v. 29. who extracts it from the Com?
mentaries of Galen. — See also Rhases, Cont. xxxiii. Galen and Rhases
remark that persons who lead an active life, such as ploughmen and la-
bourers, digest gross food more readily than any others ; but that, their bodies
being wasted by excessive fatigue, the vessels take up the chyle before it is
properly concocted and carry it over the system. Hence, such persons
bcldom attain to an old age, as their bodies get loaded with improper juices.
liV. ON THE REGIMEN FITTING FOR TRAVELLERS,
uis chapter is taken from Oribasius, (^Synopt, v. 31.) who admits that he
borrows in his turn from Diodes. The directions are upon the whole very
judicious and proper.
Galen forbids travellers who have been exposed to great cold to take heat-
ing things immediately after a journey. Meth. Med,
Avicenna, Averrhoes, and Haly Abbas direct to get bled before entering
COMMBNTART ON THE VIBST BOOK. 85
upoD a journey ; and, in certain cases, this might be a very proper practice to
prevent the blood from being inflamed by violent exercise, but, on the other
band, unless judiciously applied, it might bring on such debility as would
render the traveller unable to undergo the nece:»sary fatigue. They recom-
mend to hold in the mouth a small ball of the trochisk of camphor. The
Arabians, it is to be recollected, maintained that the action of camphor is
frigorific, and on this point Dr. CuUen agrees with them. Instead of the
draught mentioned by our author, Avicenna recommends vinegar and water.
He recommends to take little food, but of good nourishment ; and to avoid
pot-herbs and fruit. With regard to the treatment of the feet, he directs to
rub them until they become warm, and then anoint them with hot fragrant
oils. When the feet have suffered from cold, some, he says, put them into
cold water and are thereby relieved, in like manner as congealed fruits are
sometimes restored. When the water for drink is bad he advises to get it
distilled.
Haly Abbas gives very minute directions for the conduct of travellers.
Like our author, he advises to gird the body with a swath or band, and to
use a staff. He forbids to begin a journey either fasting, or in a state of
repletion with food. Exposure to the sun, he says, is apt to occasion hectic
fevers, headach, consumption, and dryness of the body. He directs to have
the head covered. When hurt by exposure to heat, he advises to pour cold
water, or any other thing of a cooling nature, over the head. After exposure
to cold, he recommends the hot bath. Pract. i. 31.
Rhases remarks, that he had known all persons who had been exposed to
great heat during a journey suffer from attacks of fever, except those of a
humid and phlegmatic temperament. He forbids to take much food before
setting out on a journey. He recommends, if convenient, to take a bath at
the close of the day, then to eat and go to sleep. He, and all the authorities
quoted by him, direct to rub the body with oil before and after a journey.
To preserve the eyes from the effects of snow and dust, he recommends to
expose them to the vapours produced by pouring wine on a heated stone,
or to those of camomile, dill, or marjoram. To protect the feet, he directs to
wrap them in cloths smeared with calefacient oils. When very hot, he
cautions against swallowing much cold water at once, but recommends to
hold some cool liquid in the mouth, and to pour cold water on the hands
and feet. He recommends travellers to chew pickled onions. It is well
known, by the way, that the Scotch Highlander can support a great degree of
fatigue by eating onions. During the prevalence of extreme cold, he ap-
proves of drinking some hot wine before setting out on a journey. When
the journey is over, he directs the traveller to go into a comfortable apart*
ment, but not to approach the fire, nor enter the bath, nor allow himself to
sleep during the space of an hour. After this, he may go into the bath and
undergo friction until his body become ruddy, and then he may go to sleep
on a soft bed ; by which regimen he may be preserved from fever, if such
be the will of God. Continens, xxxiv. Ad Mamor. vi. 3. and 4.
LVI.-— ON THB BBOIMBN OF PBRSON8 AT SEA.
This chapter likewise is taken from Oribasius, {Si/nop. v. 33.) who copies
^ Diocles. Similar directions are given by Rhases, Avicenna, and Haly
Abbas. Haly remarks that persons on board of a ship are often infested
with lice, which are engendered by want of cleanliness. For them, he re-
conmiends mercury killed, with oil, the long bithwort, &c. Pract, i. 31.
Avicenna says, that by wearing wool smeared with oil and mercury the
Hce will be killed. Can*, p. ii.
86 COMMKNTART ON THB FIRST BOOK.
When the vomiting is unusually severe and protracted, Ithases recom-
mends to treat it with anti-bilious remedies. Ad Mansor. vi. 14. Continenif
xxxiv.
LVII. — TO REDUCB OBESITY.
This is taken from Oribasius, St/nop. t. 40. Aetius uses nearly the same
words, lib. iv. 32. Celsus recommends the tepid salt-water bath, hard exer-
cise, food of an acid or austere kind, and restricted sleep, lib. i. 3.
Galen gives an interesting account of the manner in which he cured a per-
son of obesity in a very short space of time . He says : '* I first made him take
quick exercise, and aftervrards wiped off the sweat with a linen cloth. I then
rubbed his body with the volatile ointments called acopa, and after this fric-
tion I led him to the bath. I did not then give him food presently, but
directed him either to rest, or follow any occupation he was iocHned for, and
then repeated the bath ; after which, I gave him as much food, not of a very
nourishing description, as he was disposed to take." X)e Sanitate TuendOy
vi. 8.
Avicenna directs to use hard exercise and frequent baths, and to drink
vinegar, lib. i.fen. 3. d. 4. Rhases recommends to abstain from animal fbod^
wine, milk, and all sweet things; to live upon pot herbs, and siich things as
are saltish and sour ; to take purgatives and diuretics, to use much hard ex-
ercise, and to remain long in the bath. Ad Mansor. v. 61. In another work
he treats of this subject at great length. He recommends acids, and espe-
cially vinegar. In short, he agrees with Galen, that all things of a bitter,
sour, and attenuant nature, reduee obesity ; and also that saltish things which
have the property of opening the bowels do the same. Nothing, he says,
tends more to reduce corpulency than frequent baths and hard friction. Corh'
tmenSy lib. iv.
The directions given by Haly Abbas are to the same effect as those of
Rhases — that is to say, he recommends to take hard exercise, to remain long
in the bath, to use friction with oil of dill and the like, to live upon article»of
food not too nutritious, not to indulge in protracted sleep, and to have fre-
quent recourse to laxative and purgative medicines. Ptact, i. 16.
Some remarkable cases of obesity are related by Athenteus. Deipnoi. xii. 12.
The practice of the Methodists is described in a very circamstaQtial man-
ner by Ccelius Aurelianus, Tard. Past. lib. v. 9. They very properly con-
demned bleeding and purging, and depended principally upon strong exer*
cise, hard friction, and a restricted diet.
LYIII. HOW TO RECRUIT TH08B WHO ARE BMACIATBD.
Tnis is either copied from Oribasius, Sjfnop. y. 41. or from Aetiiis, till. iv.
58. The process of pitching the body is thus described by Aetius : — " Dried
pitch is melted in a moderate quantity of oil, and while still warm is to be
rubbed into the skin (the part having been previously shaved), and before it
cools completely it is to be torn away. The plaster is to be again heated at
the fire, and spread upon the skin ; and before it becomes cold, it is to be
torn away. This process is to be frequently repeated.'' Lib. iii. 180. See
Celsus, lib. i. 3.
Haly Abbas recommends moderate exercise, a short continuance in the
bath, friction with emollient oils, much sleep, two or three meals every day,
food consisting of fat meat, bread, almonds, &c. He also approves of pitch-
ing. Pract. i.l6.
COMMBNTAKT ON THE FIRST BOOK. 87
Avicenna recommends pitching, soft friction, and the rest of the treatment
recommended by Paulus, lib. i. fen. 3. Doct. 4.
Rhases treats of the same at great length. He approves of protracted sleep ;
of food consisting of fat meat, wheat, and pulse ; af\er food, of the bath, fric-
tion with oil, and the effusion of tepid water over the body ; and also of red,
thick, and sweet wines. Ad Mansor. v. 60. In another work he delivers the
opinions of preceding authorities, accompanied with his own remarks. He
agrees with Galen, that emaciation generally depends upon the state of
the liver. They recommend nutritive articles of food, such as boiled and
roasted flesh, and the bath without friction after a meal. Both speak fovour-
ably of pitching. They also approve particularly of sulphureous and bitumi-
noos baths. With regard to the bath, they explain, in another place, that it
is proper in these cases only afler the food is digested ; for, if taken too soon
after, it loads the body with unconcocted chyle ; and that, if had recourse to
at other times, it rather induces emaciation, lihases again repeats that many
of the legumina are very nutritive, which statement is con6rmed by Dr.
Colleo. He states that the vrine should be particularly thick. Continens, lib.
xiv. GaleOy in another place, says that emaciated persons are to be recruited
by thick wines, food consisting of thick juices, short exercises, and moderate
finction. Meth, Med, xiv. 16.
On the treatment of convalescents, consult Celsus, lib. iv. c. 25, Galenus,
V^g' and particularly Rhases, Continens, lib. xxxiv. We shall give Celsus'
directions in his own words :-^^ Ex quocunque autem roorbo quis convales-
dt, si tarde confirmatur, vigilare prim& luce debet; nihilominus in lectocon-
quieseere : circa tertiam boram leniter unctis manibus corpus permulcere :
deinde delectationis causa, quantum juvat, ambulare, circumcisa omni nego-
tiosa actione : tnm gestan diu : multa frictione uti : loca, caelum, cibos sspe
motare : ubi triduo quatriduove vinum bibit, uno aut etiam altero die inter-
ponere aquam. Per hxc enim fiet, ne in vitia tabem inferentia incidat, et
ttt mature vires suas recipiat. Cum vero ex toto convaluerit. periculos^ vits
genus subito mutabit, et inordinate aget. Paulatim ergo debebit, omissis his
iegibos, eo transire, ut arbitrio suo vivat." — Galen and Rhases particularly
lecommend to convalescents to drink white astringent wines diluted with
water. Both enjoin a restricted diet at first, gentle exercise, and the bath in
moderation. Haly Abbas cautions against premature friction and exercise,
bot recommends the tepid bath, and gentle unction with oils, Pract. i. 25.
Syiaat recommends the warm bath, moderate friction with rough towels, and
auction with a little oil. V. Auctores de Balneis, p. 334.
LIX. HOW TO RSMEDT EMACIATED PARTS OF THE BODY.
This is taken from Oribasius, Synops. v. 42, or Aetius, iv. 34. See also
GalenuSy de Sanitate Tuenda, lib. v. Rhases, Continens, lib. xiii. Haly
Abbas, Pract. i. 16. Avicenna, lib. i. f. 3. d. 4. All recommend to pour
water on the part, and then to rub it with towels and hot stimulant oils, so as
to produce a redness and glow in it. Most of them also approve of the pitch
plttter.
The earlier modem authors in like manner recommend fomentations, fric-
tioD, and the pitch plaster. See Lamfrancus, doc. i. tr. 3. and Theodoricus,
Kb. ii. c. 25.
LX. DESCRIPTION OF THE BEST TEMPERAMENT.
This chapter is copied from Oribasius, Synopi.v. 43. or Aetius, lib. iv. 53.
^ also Galenus, de Temperanientis, de Optima Corporis Comtitulione, de
88 COMMKNTARY ON THE FIRST BOOK.
Sanitate Tuenda, lib. v. and Ars Medka, In the last-mentioned, which was
long the most celebrated of all his admired works, he has treated of the tein*
peraments very systematically. Whatever Oribasius, Paulus, or any subse-
quent author, whether Greek or Arabian, have delivered on this subject, is al-
together derived from the works of Galen.
None of the Arabians has treated of the temperaments so learnedly as Haly
Abbas, Theories, lib. i. See also Averrhoes, CoUiget. lib. vi. Alsaharavius^
Theor, tr. vi. Avicenna, Cantica.
XLL ON THE CHARACTERS OF THE INTEMFERAMENTS.
This chapter is taken from Oribasius, St^ps. v. 44. who borrows from
Galen, Ars Med. c. 15. See also all the authorities referred to in the pre-
ceding chapter.
The ancients, it will be perceived, connected the passions and desires of
the mind with the temperaments ; and, to establish the alliance between them,
Galen wrote a treatise, wherein he has handled the subject very ingeniously,
and has delivered many profound views of the animal economy. I have often
wondered that his arguments have never been turned against the phrenologists
of the present day. The application of them I need scarcely point out, as it
mt>st be obvious that if tlie passions, affections, desires, and dispositions of the
mind, arise from the temperaments, the phrenologists have erred in referring
Ihem solely to the configuration of the skull. Galen*s work, to which I al-
lude, is entitled, QuodAnimi Mores Corporis Temperamenta sequuntur.
LXIL ON THE CONFIGURATION OF THE HEAD.
This chapter is taken from Oribasius, Synops. v. 45, Aetius, iv. 63, or di-
rect from Galen, Ars Medica, c. 6.
Psellus, like our author, remarks, that a small head, by contracting and
binding, as it were, the brain, is necessarily a bad formation ; whilst a large
head, if it arises from excess of the natural powers, is good ; but if it is occa-
sioned by a collection of superfluous matter, the contrary. Here again we
are furnished with another serious objection to the phrenological hypothesis.
For surely, granting that the passions and dispositions depend upon the con-
struction of the head, the quality as well as the quantity of its component parts
ought to be taken into account, as regulating its operations.
LXIII. — ON THE CHARACTERS OF THE TEMPERAMENTS OF THE BRAIN.
This is taken from Oribasius (Si/n. v. 46.^, who abridges Galen. Ars
Medica.
As our authoc's description of the temperaments is sufficiently intelligible,
and the others, whether Greeks or Arabians, deliver exactly the same views
of the subject, without any material improvement, I consider it unnecessary
to multiply references to, and extracts from them, on the present occasion ;
and, therefore, instead of crowding my pages with superfluous repetitions, I
shall give in this, and the five following chapters, a brief exposition of the
physiological doctrines of the ancients, with regard to the principal organs of
tlie human body : —
The ancients divided the powers or faculties of the human body into the
natural, the vital, and the animal. The brain they held to be the seat of the
animal powers — that is to say, they considered it to be the organ from which
COMMSNTAEJ ON THK FIRST BOOK. 89
sensatioD and motion are derived, and these, thev maintained, are the powers
l^ which animals are distinguished from vegetables. This doctrine is fully
explained by Galen, in his work, de FacuUatibm NaturalUnii, and by
several of the Arabian authors, among whom I will venture to mention Haly
Abbas, as being particularly worthy of being consulted on this subject. The
brain, then, was accounted the seat of the five external senses, and of muscu-
lar motion, which also was reckoned as one of the senses by Hippocrates, (De
Imomniisy c. 1 .) I may mention, by the way, that the late Dr. Brown, and
the present Dr. Abercrombie of Edinburffh, adopt the arrangement of Hip-
pocrates. Galen and his followers decidedly taught that the nerves of the
senses are distinct from those which impart the power of motion, that the
former derive their origin from the anterior part of the brain or cerebrum, and
the latter from the posterior, called by the Greeks encephalis (under this term
they comprehendea the cerebellum, tuber annulare, and medulla oblongata of
modern anatomists), or, from its process, the spinal cord. They maintained
that the nerves of the finer senses are formed of matter too soft to be the vehi-
cles of muscular motion ; whereas, on the other hand, the nerves of motion
ure too hard to be susceptible of fine sensibility. Willis, and lately Mr.
Charles Bell, in his reply to an article of mine in the Medical Gazette (May
2, 1829), on the opinions of the ancient physiologists with regard to the
nerves, deny that the nerves of sensation are softer than those of motion.
Ackerman and Malacarne, however, maintain that the opinion of Galen on
this point is perfectly correct, and with them I entirely agree. Let any per-
son attentively examine the gustatory and muscular nerves of the tongue, and
he will be sensible of the superior softness of the former. As my limits will
not admit of my giving a full explanation of this celebrated theory, which
was lately revived with great eclat, I must be content with referring to Galen,
de Usu Fartiuniy lib. ix. de AdmmUt. Anat. lib. vii. ; to Haly Abbas,
Thearica, lib. iv.; to Averrhoes, CoUiget, iii. 33.; to Avenzoar, ii. 7. ; and to
Rbases, Continens, lib. i.
The ancients were also of opinion, that the brain is the coldest viscus in the
animal frame, being in this respect the antagonist of the heart, the heat of
which they supposed that it counteracts. See Aristot De Part, Anim. ii. 7.
and Pliny, H. ^T. xi. 49. There appears to be some foundation for this opi-
nion, since, as is remarked by Haly Abbas, those parts of the body which
are vascular, and contain much blood, are naturally hot; whereas such as
contain little blood are comparatively cold. Of this latter class, are the brain,
nerves, and fat. Theor. lib. i. .
LXIV. ON THB CHARACTEE8 OF THE TEMFKEAMBNTS OF THE
STOMACH.
We shall now state briefly the opinions of the ancients with regard to the
functional office of the stomach.
Actuarius says, '' I am of opinion, that there are four species of concoction
which are performed in different parts of the body ; the nrst in the stomach ;
the second in the vena ramalis (vena portae ?), meseraic veins, and concave
part of the liver ; the third in the convex part of the liver and veins proceed-
mgfrom it; and the fourth, consisting of febrication or assimilation which
takes place in the extreme parts of the body.'' De UrinU. The various
modes of change or concoction which the food undergoes in the body, are
minutely described by Macrobius. Satumal, lib. vii. In another place,
Actuarius says, '* Digestion is performed by moderate heat and moisture.*'
De Spiritu Animali, p. ii. § 1. Alsaharavius in like manner states, that the
digestive faculty depends partly on the heat, and partly on the humidity of
90 COMUKNTART ON THB FIRST BOOK.
the stomach. Praet, it, xvi. c. 1. It is impossible not to see that the
gastric juice is alluded to in these passages. It is particularly stated of Ascle-
piadesy that he held digestion to be the solution of the food. — See C. Aure-
lianus, i. 13. And that the ancients were aware that the stomach secretes
a fluid possessed of solvent properties, is put beyond a doubt, by the follow-
ing extract from the works of Haly Abbas. Speaking of the changes which
the food undergoes in the mouth and stomach, he says : — " Iramutantur cibi
in ore, retinenturque, et flegmati admiscetur quod digestum est, calorque ei
datur. Quod antem flegma hoc hujusmodi sit, signum nobis est quod im-
petigines et sarpedones curat, quedam maturat ulcera, scorpiones necat.
liac ergo de causa et in ore cibus immutatur. Sic et stoma'shus ipsum im-
mutat: ejus etenim circum amplectitur substantia, quasque habet imprimit
qualitates, immutaturque ipsius natural! calore cibus : Sed et quoniam cibus
ipse M eo flegmati admiscetur humidor Theor. iv. 3. The whole bearing
ai this passage, but more especially the last clause, puts it beyond a doubt,
that the process of digestion was supposed to be performed, in a certain
measure, by the solvent powers of a fluid secreted in the stomach. And the
ingenious Alexander Aphrodisieus, in like manner, treating of the digestion of
mustard, pepper, and other acrid substances, says decidedly, that their acri-
mony is dissolved in the copious fluid of the stomach. Frohl. i. 30. — See
also Macrobius, Saturnalia^ lib. vii. 8. He calls it ventralis humor. Part
of the process was, no doubt, supposed to be performed indirectly by heat ;
and deservedly, for even Spallanzani was compelled to admit, that the com-
parative temperature of animals exerts a considerable influence on their di-
gestive powers. Hence, as was stated by Averrhoes, and as is confirmed by
Cuvier, birds, which are the warmest class of animals, likewise digest the
fiutest. At all events, the ancients were well aware, that digestion is not a
mechanical, but a vital process, being performed by the principle of life.
*^ Digestion,'' says Averrhoes, '' is performed by concoction, and the concoc-
tion is influenced by heat, not that the first mover in the operation is heat,
but the nutritive soul ; because the operations of heat are indeterminate, and
not directed to any manifest end.*' Celliget. v. 3. In the AverroeanOf or
XiCtters from Averrhoes to Metrodorus, the doctrine of a gastric menstruam
is discussed with singular ability. Metrodorus states, that ^ he found by the
Wfitings of the physicians and philosophers of these times, that they make
the menstruum^ as they call it, whereby both appetite is provoked, and food
in the stomach is digested, to be a certain juice or humour in the stomach,"
&c. Averrhoes denies that this menstruum acts by its acidity alone.
LXy.--*-ON THE CHARACTBR8 OF THE LUNOS.
The ancients were of opinion, that the lungs are an accessory organ, made
to administer to the heart. ^ It is the heart," says Aretseus, ^ which imparts
to the lungs the desire of drawing in cold air.'' They, of course, were aware
that respiration is the functional office performed by the lungs ; and, respecting
the uses of this vital process, they were pretty much agreed. Aristotle, in-
deed, and the older physiologists taught, that refrigeration is the purpose of
respiration ; but Gralen explains, that, probably, they were at a loss for a pro-
per term, and used it in the sense of ventilation. Galen, himself, perpetually
inculcates, that, by respiration the vital heat is regulated, being increased or
diminished according to the circumstances of the animal. Another purpose,
which he, Haly Abbas, and other ancient physiologists supposed to be per-
formed by respiration, is the evacuation of the fuliginous vapours of the
blood. Galen was awai'e that respiration produces the same efifect upon at-
mospherical air that combustion does, and that it is equally necessary to the
COMMKIITART ON THK PIEMT BOOK. 91
one proceis and the other.— See the treatises of Aristotle and Galen on re-
SiratioDy and Haly Abbas, ThearUa, lib. iii. The following extract from
aly contains the summary of what we have been stating:-—*^ Respiration
is necessary, for the sake of the heart, which is the fountain, and, as it were,
the focus of vital heat, whence it is diffused over the rest of the body. It re-
quires some aerial substance to ventilate the heat and ebullition of the heart,
and in order to evacuate the fuliginous vapours which are found in it.*'
LXVI.— ON THB TBMPBmAMBNTB OF THB HBART.
Im the ancient system of physiolosy, the heart was considered as the seat
of the vital powers, its office being die preservation of the innate heat of die
body. The philosopher, Aristotle, had pointed out the connexion between
Iieat and vitality, and had taught that the heart, as being the centre of heat,
is the prime organ in the animal frame. Hence, as his commentator, Averr-
boes, remarks, it is the primum movent et tUtimum moriens, Galen, however,
maintained with Hippocrates, that the animal frame is a circle, having neither
beginning nor end, and that, consequently, it has no prime organ. He
taught that the brain does not, properly speaking, derive its powers from the
heurk, nor the heart from the brain ; but that these organs are mutually de-
pendent upon one another, the heart being indebted to the brain for sup-
plying the parts concerned in respiration with muscular energy, and the braiti
being indebted to the heart for its vital heat, without which it could not con-
tinue to be the vehicle of sensibility and motion. We have mentioned in
the preceding chapter, that the ancient physiologists looked upon respiration
as being a process similar to combustion. Agreeably to this idea, they com-
pare the hc«rt itself to a lamp, — its vital heat to the flame of the lamp, and
the blood to the oil which foeds the flame. — See Galenus, de Utu Respirathnit,
Alexander Aphrodisieus, Probl. i. 16.
The heart, then, was supposed to convey heat to all parts' of the body, by
means of the animal spirits incorporated with the blood in the arteries. Re-
specting the contents of the arteries, two hypotheses divided the ancient
schools of medicine. The first was that of the celebrated Erasistretus, who
maintained, that the arteries do not contain a fluid, but merely certain airs
or vapours. This hypothesis was revived about 70 years aeo, by Professor
Rosa, in Italy; and lately it found a xealous abettor in my lamented friend,
Mr. George Kerr, of Aberdeen. The other hypothesis was that of Galen,
who keenly attacked this, as he did most of the tenets of Erasistratus, and
endeavoured to prove, by experiment, observation, and reasoning, that the
contents of the arteries is blood, mixed, indeed, with a certain proportion of
heat and airs, but in every respect a fluid, little difierent from that which is
contained in the veins. It was also part of his system, that the right cavity
of the heart attracts blood from the liver, and conveys it to the left, from
which it is diflbsed all over the body by the arteries. He taught that, at
every systole of the arteries, a certain portion of their contents is discharged at
their extremities, namely, by the exhalents and secretory vessels ; and that at
every diastole a corresponding supply is attracted flrom the heart. He de»
cidedly inculcates, that it is the expansion or diastole of the artery which oc-
casions the influx of the blood, and not the influx of the blood which occasions
the expansion of the artery. Though he demonstrated the anastamosis of
arteries and veins, he nowhere hints his belief, that the contents of the former
pass into the litter, to be conveyed back to the heart, and from it to be again
diffused over the body. Of the greater circulation of Harvey, he certainly
had no idea. In a word, his system appears to have been nearly, or alto-
gether, the same as that afterwards taught by the unfortunate Servetus.
92 COMMENTARY ON THB FIRST BOOK«
In proof of the opinioDs which I have attributed to Galen, I refer the
reader to An Natura Sariguinis sit in Arteriis, Administ, Anatom, vii. 15, de
Vsu Partium, lib. vi. and lib. vii. 7, 8, 9, de Placitis Hippocr, et Plat. i. 5.
See also Averrhoes, Colliget. ii. 8. ii. 9. Collect. § i. 9. In Cant. Avic.
tr. i. p. 1. — Avicenna, lib. iii. fen. xi. tr. 1. — Actuarius, (/e Spiritu Animali^ p.
i» § 6. c2e Causis Urinarumj ii. 2. — Nemesius, de Natura Hominis, § 24.
With regard to the passages collected by the ingenious M. Dutens, fix>m
the works of Hippocrates, Plato, Nemesius, Pollux, and Theodoret, to prove
that the ancients were acquainted with the circulation of the blood, as taught
by Harvey, I shall only remark, that, after having attentively considered then),
I cannot but draw the conclusion, that some of these authors must have had,
^t least, an obscure idea of this doctrine, although, in general, these passages
paay be understood to refer merely to the lesser circulation and the move-
meut of the blood from the centre to the extremities, as maintained by Oalen.
— See Dutens, Origine des Decouvertes attributes aux ModemeSy p. 157, —
also Drelincurtius, de Lienosis Epimetris.
LXVII. ON THE TEMPERAMENTS OF THE LIVER.
AccoRDiKG to the views of the ancient Physiologists, the liver is the seat
of the natural powers, being the grand organ of sanguification, and the blood
being the pabulum which nourishes the whole body. That the liver per-
forms an important part in the fabrication of the blood, seems probable from
all the veins of the stomach and upper* portion of the intestines passing
to th^ liver, whereby it is to be supposed, that a considerable proportion of
the nutiitive juices will be conveyed to it ; and from this viscus being pro-
portionally large in the fcetus when it is much required to form blood, and
cannot be supposed necessary for any other purpose. In fact, the late ex-
periments of Professors Tiedeman and Groelin seem to prove, that the liver
IS concerned in carrying off the recrementitious part of the blood, or, to use
the language of modem chemistry, in decarbonising it. Recherches Exper.
sur la Digestion. The ancients taught, that the liver, by its attractive power,
attracts the chyle from the stomach ; that, by its retentive, it retains the same
until the alterative convert it into blood ; and then the expulsive separates
the superfluities of the blood, namely, the bile, and conveys them to the gall-
bladder.— See Galenus, tom. ii. p. 285. Ed, Basil, and Avicenna^ lib. iti.
fen. 4. tr. 1.
Aristotle held that the spleen is part of the hepatic system, de Partibm
Animal, iii. 7. His commentator, Averrhoes, in like manner, considers the
spleen as a second liver. Collect, i. 9. Their reasoning, on this point, ap-
pears to me exceedingly acute and conclusive.
LXVIII. ON THE TEMPERAMENTS OF THB TESTICLES;
The testicles were described by the ancient anatomists as being bodies
xomposed of white glandular flesh, and surrounded by coats which they
Jcnew to be processes of the peritoneum. The semen they considered as a
white frothy fluid, elaborated from the blood, by passing through the convo-
lutions of tne spermatic vessels. Aristotle held it to be a superfluity collected
from all parts of the system. His theory of generation is similar to that of
Buffon. For the hypothesis of the Epicureans, see Lucretius, de R. N. lib.
iv. They taught that the foetus is the joint-production of the male semen, and
something analogous secreted by the ovaria of the female.
COMMSNTART ON THB FIRST BOOK. 93
LXIX. — ON THR PARTS WHICH ARS OMITTRD.
On these consult Galenus, de Temperameniis. — Haly Abbas, Tkeor. iii.—
Avicenna, lib. i. fen. 1. doct. 3. We may mention that, generally speaking,
all those parts which possess much blood were supposed to be of a not tern*-
peramenty and those which baTe little of a cold.
LXX. ON THR CURR OF THR HOT INTRMPRRAMRNT8 OF THR BOOT*
See in like manner Galeous, de Sanitate Tuendoj lib. vi. — Oribasius, Syn:
V. 51. — Aetius, iv. 95. — ^Actuarius, de DUBta, c. 12.— *Of the Arabians, Haly
Abbas is the author who has delivered the treatment of the temperaments in
the fullest manner, Pract, i. 15.
It is ta be remarked, that the condition of the body named the hot intern^
perament by the ancients is the same as that now generally called a bilious
habit. Accordingly, Galen directs the physician to attend whether any pain
or sense of weight be felt in the region of the liver, as, in that case, he judges
it unsafe to take the bath after a meal, and recommends rather to give deob*
straents, and to avoid food of a thick viscid nature. He particularly recom-
mends an attenuant diet, and medicines of the same description, namely,
wormwood, anise, bitter almonds, &c. His views of practice in this case
appear to bave been very judicious.
LXXI.— ON THR CURR OF THR COLD INTRMPRRAMRNT8.
See the authorities referred to in the preceding chapter. All, in a wordj
copy from Galen.
LXXIl. OF THR CURR OF THR DRY INTRMPRRAMBNTS.
Galen supplies all the matter of this chapter.
This being me last chapter in which the temperaments are treated of, it
maybe interesting,- before concluding with them, to give a brief exposition of
modem opinions on this subject. We shall select the account of them given
by Dr. CuUen in his work on the Materia Medica. He says, ''The ancients
very early established a distinction of temperaments, which the schools of
physic have almost universally adopted ever since, and appears to me to be
founded in observation.*^ He then proceeds to describe what he calls the
four temperaments, namely, the sanguine, the melancholic, the choleric, and
the phlegmatic. In the sanguine, he says, the hair is soft, and never much
nurled, is of a pale colour, and, from thence, passing through the different
shades to red ; the skin is smooth and white ; the complexion ruddy ; the
eyes commonly blue; the habit of the body soft and plump; after the period
of manhood, disposed to obesity, and at all times readily sweating upon ex-*
ercise ; the strength of the whole body moderate ; and the mind sensible,
irritable, cheerful, and unsteady. This, he says, is the tentperamentum calidum
et humidum of the ancients. He adds, the other temperament distinguished
by the ancients, which I can characterise most distinctly, and explain most
clearly, is, that which has been very constantly named the melancholic. The
hair is hard, black, and curled ; die skin is coarser, and of a dun colour,
with a corresponding complexion ; the eyes very constantly black ; the habit
of the body rather hard and meagre ; the strength considerable ; the mind
94 COMMENTARY ON THB FIRST BOOK«
slow, disposed to gravity, caution, and timidity, with little sensibility or irri-
tability, but tenacious of all emotions once excited, and, therefore of a great
steadiness. This, he says, the ancients made the temperamentumfrigidum et
tkcum. A temperament intermediate between the sanguine and the melan-
cholic, is the one which the ancients meant to denote by the title of choleric,
which has more strength than the sanguine, and more irritability than the
melancholic. In the phlegmatic, there are less sensibility and irritability,
but with more strength and steadiness than in the sanguine ; and, at the
same time, with more laxity and more irritability than in the melancholic.
Such is Dr. Cullen's description of the temperaments, which, as must be ob-
vious to the reader, contains a very erroneous account of the ancient doctrines
on this subject.
The modern ideas respecting the temperaments, appear to be founded
upon the descriptions given by the Arabians of the symptoms, which charac-
terise the prevalence of the four humours, as they were called, namely, blood,
yellow bile, black bile, and phlegm, in the body. In proof of this, I sub-,
join Rhases' brief description of them : — '^ De complexione autem infirm!
scias, quod si fuerit albi coloris admixti rubedini, et si fuerit bone camis,
subtilis cutis, et quando locum fricaveris, rubescit statim, significatur quod
materia est sanguinea. £t si corpus fuerit pingue, et albi coloris non mixti
rubedini, et corpus nudum pilis, venb strictis, came molli, occultarum juDC-
turarum, gracilium ossinm, et generaliter talis dispositio qualis est in corpo*
ribus muUerum, significatur quod materia est pnlegmatiea. £t si fuerit
macrum, citrini coloris, pilosum, et cum crassis venis, et manifestis junctu-
ris, ostendit quod materia est cholerica. £t si fuerit niger color, durities cor-
poris, pilositas, asperitas cutis, significatur quod materia est melancholica." —
Ve Affect, Junet, c. 2.
It is to be understood, however, that Galen's system of the temperaments
was not based, as has been often erroneously represented, upon any hypo-
thesis respecting the humours.
LXXIII.-^ON THB PB0PBETIB8 OF FOOD.
The ancient writers on Dietetics are, Hippocrates, de Diata, de Affectioni-
bui, et alibi. — Celsus, lib. ii. — Dioscorides, Mater, Med. lib. ii.—^alenus,
de Faeult, Alim, et, de Probis Pravisgue Aliment, Sw, Oribasius, Med. Col-
lect, lib. i. et seq. — ^Aetius, lib. iiw^-Simeon Seth, de Alimentis, — Actuarius,
de Spiritu Animaliy p. ii.— Rhases, ad Mamor, lib. iii. Continent, lib.
xxxiii. — Avicenna, Cantic, p. ii. Averrhoes, Comment, de Cantic. — Haly^
Abbas, Theor, v. 15. — ^Athenseus, Deipnot. panim, Plutarchus, de Sanitate
Tuenda, Symposiacon, — Macrobius, Satumal. lib. vii. — Cslius Apiciusy de
Opsoniit, — Geoponicny lib. xii.
The ancient philosophers were at great pains to explain why a regular
supply of food IS necessary to the existence of animals. On this su^ect,
Timeus Locrus, Plato, and Aristotle, have philosophised with great acute-
ness and ingenuity. No one, however, has given a plainer account of the
matter than the Poet Lucretius in the following verses : —
** lUnd Hem non est mirandum, corporis ipsa
Quod natura cibum quierit quoifisqae nni mantis \
Ctuippe etenim fluere, atque recedere corpora rebus
Mnlta modis multis docoi, sed plurima debent
Ez animalibus lis, qus sunt exerdta motu ;
Multaqne per sudorem ex alto pressa fenmtur,
Malta por os e^dialantiir^ qaom laagoida anhelant :
Hit igitar rebus raresdt corpus ; etomnis
OOMMBNTART ON TUB FIRST BOOK. 95
Subrnitar natnra dolor quam consequitur rem.
Propterea Cfq>itiir dbufl, ut suifalceat artas,
£t recreat yins interdatasi atque patentem
Per membra ac Tenas vt amorem obtnret edendi."
De Renm Ntt, W. 1. 866.
The explanation given by one of Rbases's authorities is to the same effect.
He says — '^ Since our bodies are in a continual state of waste from the sur-
rounding atmosphere, and the innate heat which is within, it behoved them to
have nourishment to supply the part which is melted down ; and, as all the
food which is taken is not assimilated, it was necessary that there should be
passages for the discharge of the superiSuities."
Hippocrates, Aristotle, Galen, and Musonius (ap. Stobci Sentent» s. 18.)
remark that the stomach is to animals what the earth is to vegetables.
Our author's general remarks on the properties of food are condensed from
Galen's work, l)e Prob. p. AL tuc, Horace agrees with Galen and our
author in condemning the mixture of various articles of food, Satir, lib. ii. s. 2.
The arguments for and against this practice are very ingeniously stated by
Macrobius, Saturn, vii. 5, 6. It appears that Asclepiades maintained the opi-
nion that a multifarious diet is most easily digestea. Celsus, iii. 6.
With regard to the ordinary meals of the ancients, the following extract
from the notes of Lambinius on Plautus will supply the necessary informa-
tion:— ^^Jentaculum primus erat cibus apud Komanos ut apud Gnecos
oKpaTurfjui; quem sequebatur PranJium ; deinde Vesnerna; postremo Cana:
apud Graecos dpurrov, deinde i<nr€purfjLaf postremo oeiirpovJ* Truculent. Ac.
ii. sc. 7. I. 38. See also Athenaeus, Deipnos. lib. 1. and Potter's Archaohgia
Graca^ lib. iv. 16. The practice, however, of taking so many meab, appears
to have been disapproved of by the physicians and savam : mr we find Actn-
arius discussing the question, whether it be proper to eat twice, or only once
Id the day; and Galen decidedly recommends not to take food in general
oftener than twice. Cicero even forbids to take two fiill meals in a day. (Tup-
cuL Quasi, lib. v.) Haly Abbas enters into a full examination of the question
with regard to the numoer of meals. Some, he says, eat only once in the day,
some twice, and others three times. He advises those persons who are ac-
tively employed not to dine, because, if obliged to take exercise immediately
afterwards, the body will be loaded with half concocted chyle. Upon the
whole he prefers supper to dinner. Pract. i. 13. Alsaharavius considers one
meal in the day not sufficient for persons of a gross habit of body. He ad-
vises not to change even a bad regimen too suddenly. Rhases remarks, that
to take another supply of food before a preceding meal is digested, will provt
highly prejudicial to the health.
The ancient physicians attached extreme importance to the proper regu-
lation of the diet. Galen seriously admonishes his readers not to eat
thoughtlessly, like brute beasts, but to consider attentively what kinds of food
and drink they find from experience to be prejudicial to them. De Sanitate
Tuenduy lib. vi. 13.
According to Athenaeus, a good physician ought to be a good cook. —
Deipnos. lib. vii.
LXXrV. ON POT'HBRBS.
Athemjeus remarks that the use of pot-herbs as articles of food appears to
have been very ancient, since several of them are mentioned by Homer.
Det/mo«. i. 29. Diphylus says, '' that all pot4ierbs in general contain little
nutriment, are attenuant, engender bad juices, swim in the stomach, and are
of difficult digestion." Deipnos. ii. 28. Actuarius states, that pot-herbs in
)
96 COMUBNTART ON THE FIRST BOOK.
general form a thin and watery blood, compared with that from thicker arti-
cles of food.
The ancients ate their pot-herbs with much oil, and generally a liberal al-
lowance of hot spices. See Apicius, lib. iii. A sauce from pickled fish,
vinegar, or old wine, was often a^ded to the preparation. The poet Juvenal
makes mention of a miser who ate his cabbage with the oil from lamps.
Sat, V. 1. 87. Celsus remarks of such things, " Quodcunque ex olio garove
estur olus alien um stomacho est.*'
We shall now select from the dietetical writers a few remarks on some of
the articles of this class :
Galen strongly commends the Lettuce as a cooling, moistening, and
soporific herb. He relates that he cured himself of morbid insomnolency,
by eating liberally of lettuces. The soporific property of lettuce is men-
tioned by Dioscorides, Pliny, Athensus, Rhases, Haly Abbas, Simeon Seth,
and most of the other authorities. It is even said by Simeon Seth, and Flo-
rentmus {Geopon. xvii. 13.), that the juice of it when rubbed upon the fore-
head induces sleep. 1 need scarcely remark, that the lettuce was lately re-
stored to its place in the Meteria Medica as a soporific. Martial directs to
eat lettuce at the beginning of a feast. Lib. xi. £p. .53.
Athenseus mentions that Mallows are praised by the poet Hesiod,
{Op, et Dies. lib. i.) He adds, *< Diphilus relates that mallows have good
juices, smooth the trachea, are easily evacuated, and prove moderately nutri-
tious.'' Damogeron says that, when eaten with nsh-sauce and oil, they
loosen the belly. Geopon. u. s. Galen and Aetius state that they lubricate
the intestines more than lettuce, but are not so refrigerant. In a word,
mallows were in great repute with the ancients as being inferior to none of
olera. Horace calls them, " gravi malvae salubres corpori," Epod. ii. The
poet Martial mentions them as being laxative. Lib. x.
Galen states, that the juice of the Beet is thinner and more detergent than
those of the lettuce and mallows. He says that, when twice boiled, it be-
comes astringent. Apicius recommends to eat boiled beet with mustard, a
moderate proportion of oil, and vinegar. Beet-root, according to Actuarius
and Simeon Seth, is difficult to digest, flatulent, and laxative. Dioscorides
and Diphilus, however, state, that beet contains better juices, and is more
nutritious than cabbage. Athen. Deipn, ix. Galen recommends its pickled
roots as a deobstruent for infarction of the liver and spleen. De Alim. Fa-
cult, lib. ii.
The wild Succory, and the Endive or garden Succory, were much used by
the ancients as pot-herbs. Galen briefly states, that in properties they re-
semble lettuce, but are less delicious. According to Simeon Seth, they are
slightly cooling and moistening. The endive, he says, when boiled with
vinegar, is astringent. Rhases praises it as a deobstruent in aflections of the
liver. Apicius directs to dress them with fish-sauce and oil. Its boiled
roots were also prepared as a pickle.
The Brassicae or Cabbages were great fevourites of the Elder Cato. De He
lUat, Horace states correctly, that such as grow in the country are better
than those which are raised about towns. Sat, ii. 4. According to Galen,
their juices are laxative, but their solid parts astringent. Brocoli, says
Rhases, when not pickled, are not heating, and being flatulent they engender
semen. Those that are pickled are more heating, occasion thirst, supply bad
nutriment, and inflame the blood. Is Brocoli an Italian word, or an Arabian,
formed from caulis with a prefix ?
The Halimus, according to Sprengel, is undoubtedly ihe Atriphx Halimut
L. called by Miller the Sea Purslane, Dioscorides says, that its leaves when
boiled are used for food, lib. i. 120.
COMMENTARY ON THE FIRST BOOK. 97
Rhases and Haly Abbas state, that Spinage is laxative and wholesome.
The Greeks and Romans appear to have l>een unacauainted with it.
The Atractylis is supposed by Sprengel to be the Carlina Lanata L. Dios-
corides and Pliny recommend it as an antidote against poisons ; but it seems
to have been little used as a pot-herb.
The Scandix, or Shepherd's Needle, was in little repute as an article of
food ; and hence Aristophanes makes it a subject of reproach to Euripides,
.that his mother sold not good pot-herbs, but Scandix. Achar, act. ii. sc. 4.
Plinius, If. N, xxii. 38.
Galen says, that the Gingidium is eaten in Syria, like the Scandix in his
country. It has been supposed to be the Chsrophyllum or Chervil ; but, ac-
cording to Ludovicus Nonnius, this is a mistake.
Galen, Aetius, and Simeon Seth, speak of the Artichoke as an unwhole-
some pot-herb. It may be eaten, however, Galen says, with oil, fish-sauce,
and wme and coriander. Dioscorides says, that the Scolymus is eaten Kke
asparagus. lib. iii. 16.
The Hipposelinum appears to have been the Sm^mium Olusatrum. — Sec
Harduin's note on Pliny, If. N, xix. 48. and Sprengel, ap, Dioscor, iii. 71 .
Dioscorides says, it is used as a pot-herb like parsley, its root being eaten
boiled or raw, and its stalk and leaves boiled, either aloue or with fish.
It is not to be coniounded with the Smyniium of the ancients. Dioscorides
says, thai the latter, when pickled, is used as a pot-herb, and is astringent.
Galen says, that the Blite and Orache are watery pot-herbs, and almost in-
sipid. Seth, and the other authorities who notice it, agree, that the latter is
coolii^ and laxative. The Blite is still much used as a pot-herb in Spain and
Italy,
Xenophon mentions, that the ancient Persians lived very much upon
Cresses. Cyroped, i. 2. According to Aetius and Simeon Seth, they are cale-
iacient and desiccative. Seth calls them aphrodisiacal. On the aphrodisia-
calpoiiers of the Cresses and Rocket, see Chapter 36th.
Dioscorides says, that the root of the Dracunculus, or Dragon herb, is some-
times eaten as a pot-herb, both when boiled and raw. He mentions, that the
inhabitants of the Balearian Isles mix its root with honey, and use it at their
banquets in place of cakes. Lib. ii. 16. Simeon Seth notices it by the name
of Taichon, being a corruption from Tarragona. He calls it flatulent and un-
wholesome ; and says, that its leaves only are to be used along with mint
and parsley. Galen and Rhases likewise mention it as an article of food. It
is still used on the Continent for salads, and an excellent pickle from it is
brought to this country.
Mustard, as Hippocrates remarks, is of a hot and purgative nature. Seth
says, that it promotes the digestion and distribution of the food. Rhases for-
bids to eat it, except along vrith thick articles of food.
Pliny mentions the Ocymum or Basil in very unfavourable terms.
Cappers, say Aetius and Seth, consist of different qualities, as bitterness,
whidi renders them detergent, purgative, and penetrative; acrimony, which
makes them calefacient, discutient, and attenuant ; and sourness, which ren-
ders them astringent. Serapion says that, when pickled with vinegar, they
strengthen the stomach, and whet the appetite. When pickled with salt, he
says, they are bad for the stomach. Galen recommends pickled cappers in
ot)structioii of the Liver and Spleen.
The Bouglossum, or Borage, is frequently mentioned as a herb, which,
when eaten, imparts gladness to the soul. Ludovicus Nonnius informs us,
that the Belgians still fancy that it possesses this property, and look upon
it as the Homeric Nepenthes.
We have had occasion to mention in another place, that the ancients were
fully persuaded of the aphrodisiacal properties of the Eruca, or Rocket.
n
98 COMUBNTARY ON THE FIRST BOOK.
LXXV. ON ASPARAGI, OR YOUNG SHOOTS.
<' Asparagus. The first sprigs of Herbs before unfolded unto leaves, and the
youngest and tenderest branches that are eatable, are called Asparagus/'
Miller's Gardener*s Dictionary, — See also Suidas in VocCy Galenus de Alim.
Facult. Humelbergius, ap. Apul. de Med. Hist. c. 84. Our authofs ac-
count of the Asparagi is aoridged from Galen. He remarks, that the young
shoots of the cabbage, called Cymae, are particularly tender. Apicius di-
rects to prepare them with cumin, salt, old wine, and oil ; to which pepper,
borage, and the like may be added.
On the Asparagi, see Athenseus, Deipn, lib. ii.
The Plant now commonly known by the name of Asparagus or Sparrow-
grass, is said by Simeon Seth to be so nutritious, that it deserves to hold an
intermediate place between pot-herbs and flesh. He remarks, that it is diu-
retic, and imparts its smell to the urine. The wild Asparagus is called
Corruda'by Cato, Columella, and Pliny.
LXXVI. ON HERBS HAVING ESCULENT ROOTS.
Galen thus delivers the general character of these substances: "The
roots of Pot-herbs which are acrid, such as those of onions, leeks, garlic,
radish, and carrot, contain bad juices ; but those of turnips, rapes, and cara-
ways, hold an intermediate place between things of good and of bad juices.'*
It is well known, that the Romans had two kinds of Herbs with esculent
roots called the Napus and Rapum, and that they are generally admitted to
have been two species of the Turnip. — See Columella, ii. 10. — ^Pliny, H. N.
Yviii. 13, and the note of Harduin. — Dickson's Husbandry of the Ancients,
c. 33. — Sprengel, R. H. H vol. i. The term Bunias occurs first in Nican-
der; and that it was synonymous with the Gongylis, is declared by Galen
and our author ; and, further, that it was the Brassica Napobrassicu L, is
admitted by all the late authorities on classical botany, with the exception of
Dierbach, who most unaccountably contends, that it is the B. Oleracea,
Galen says that, unless well boiled, it is~ indigestible, flatulent, and bad for
the stomach. Seth assigns it the same qualities as our author. All account
it diuretic and aphrodisiacal. Apicius directs to eat the Rapa or Napi with
cumin, rue, vinegar, oil,&c. Lib. iii. c.fS. — It appears from Athensus, that
the ancients frequently ate their Turnips roasted.
It is not well ascertained what the Esculent Bulbi of the ancients were.
Harduin conjectures that they were a delicious kind of onions. Matthiolus
and Nonnius are wholly undecided. Sprengel inclines with Dalecampius
and Sibthorp to think that they were a species of Muscari, or Musk Hyacinth.
The account of them given by Serapion, who calls them Cf/pa sine tunicis,
agrees better with the conjecture of Harduin. Eustathius likewise says, that
the Bulbus was a wild onion. Ap, Iliad, xiii. 589. Columella calls them
aphrodisiacal. Lib. x.
The Staphylinus was unquestionably the Carrot. Apicius, among other
methods of dressing it, directs to do it with salt, pure oil, and vinegar.
The Carus seems indisputably to have been the Carum Carui L. Dios-
corides says, that its boiled root may be eaten like the Carrot. Seth praises
it as being carminative, diuretic, and astringent. Apicius mentions it fre-
quently along with spices and other aromatics.
The characters of the onion, garlic, and leeks are taken from Galen. Cel-
sus calls them calefacient, and ranks them with things having unwholesome
juices. We have mentioned, in another place, that the Scotch Highlander
COUMBNTARY ON THB F1&8T BOOK. 99
eats ODioDS to enable him to support the fatigues of a journey. Dr. Paris
considers this a proof that they are very nutritive, but I am disposed to
think, with the ancient authorities, that they are merely hot stimulants. Ac-
tuarius prefers the leek to the onion and garlic. The latter is warmly
eulogised by Gralen as being the rustic's Theriac. Horace had not so much
^voor for it. Epod, iii. Galen calls the Ampeloprason the same as the
wild LedL. De Fac, Simp, vi. Dioscorides descnbes two species of the
Pormm, namely the Capitatum and Sectivum.
Galen directs to eat Kadish before dinner. He justly expresses his sur-
prise at the practice of certain physicians, and other persons of his time,
who ate Radish after dinner to promote digestion. The wild Radish was
called Armoraciab^ the Romans.
LXXVII.— ON MUBHROOMS AND TRUPFLB8.
DiPHiLUs says, ^ that Fungi are grateitil to the stomach, laxative, and
nutritious, but of difficult digestion and flatulent.'' Athen. Deipnos. ii. 19.
Diphilus says '' that the nature of Truffles is, that they are difficult to digest,
supply goodjuices, and are laxative ; but that some of them like the Fungi
occasion suffocation." Ibid. c. 51. Galen says, that they contain cold,
viscid, and thick juices. Serapion says, that they engender gross humours.
According to Avicenna, they are apt to superinduce Apoplexy and Pa-
ralysis. Simeon Seth says, that Truffles occasion cruae and depraved
humours. He directs to allow them to steep in water for some hours oefore
boiling them ; and to prepare them with pepper, marjoram, salt, and rue, to
collect their bad properties. Rhases, in like manner, recommends to eat
Truffle boiled in water with salt, marjoram, oil, and assafatida. He advises
to take wine, honied water, or the Theriac, after Mushrooms. Apicius
directs to eat Fungi with pepper, oil, salt, &c. Horace points out the best
Idnd of Fungi :
^* Pratensibiis optima fungia
Natora est : alus male creditur.*' — SaL ii. 4«
The poets make frequent mention of Mushrooms as a delicacy at the
tables of Gourmands. — See in particular Juvenal, Sat, v. 145.
Apicius directs to preserve Truffles, by laying them in a vessel along with
akemate layers of saw-dust, and then covering up the mouth of the vessel
with paicet. On the mode of raising them, see Geopon, xii. 41. In the
days of Juvenal, the Roman Gourmands appear to have attached more im-
portance to the Tribes than the com which they were supplied with from
Africa:
'' TiU habe fromentom, Alledius iaqiiit,
O Lybie ; diiyuiige boves dum tubera mittas.*' — Sat, v. v. 116.
In a celebrated modem woric the Truffle is called : << Un tubercule qu'
en ne peut mettre dans la classe des legumes ni des fruits." — Aim, de$
GourmamdSf vol. viii. p. 4.
Ludovicus Nonnius confesses himself unable to determine what species of
Mushroom the Amanitas of our author were. Seth makes no distinction be-
tween them and the Mycetse.
LXXVIII. — ON THB FRUMENTACEA.
On the Ceiealia consult in particular Theophrastus, If. P. lib. iii.
Dioscorides,^ lib. ii. GalenHs, de Aliment^ lib. i. Plinius, If. N, lib. xviii.
SerapioB, de Simpl, Harduin, Nota in Plin. I. c. Paucton, Metrologies
h2
100 COMMENTARY ON TH£ FIRST BOOK.
Dickson*s Husb, of the Ancients. Sprengel, R. H, H. and Nota in Dioscan
I. c. and Ludovicus Nonnius, de Re Cibaria, lib. i.
AmoDg the Cerealia^ Wheat, as Galen states, deservedly holds the first
place, as being in most general use, and containing the most nutriment
within a small bulk. He remarks, that it is the most glutinous of all the
articles of this class. And here, by the way, I must beg leave to dispute
the correctness of Dr. Cullen*s statement, that Beccaria of Bologna, about
the year 1728, first discovered that Wheat contains a glutinous matter.
Haly Abbas likewise states, that Wheat is the most nutritious of all arti-
cles of food. Pliny asserts the same thing of it. He calls the Siligo the
delicia tritici, Galen explains the Siligo and Similago in much the same
terms as our author. The third species, or the AutopyruSy he says, consists
of all the parts of the grain, the bran not being excluded. Actuarius, on the
other hand, says that the bran only is rejected. Is not the text of the latter
corrupt ? Bran, Galen adds, is detergent and contains little nourishment.
Tryphon, in Athenaeus* Deipnosophista, states, tliat this thirjd kind of Flour
is the most laxative.
Theophrastus mentions that the lightest Wheat imported to Greece in his time
was the Pontic. It is curious to remark, that Odessa Wheat still retains its
ancient character. The heaviest, he says, was the Sicilian, which, however,
was lighter than the Bsotian. Pliny says, that the lightest Wheat brought
to the Roman market was the Gallic, and then that imported from the Cherso-
nese. The first in excellence, he adds, are the Baeotiau, the Sicilian, and
next to these the African.
Galen gives an interesting account of Bread. The best kinds, he says,
are such as contain plenty of yeast, have been properly pounded, and exposed
to a moderate heat in the oven. When exposed to too strong a heat, be
properly remarks, that a crust is burned on the outside, while the inside is
left raw or improperly concocted. Unleavened bread he wholly condemns.
Celsus appears to have had a better opinion of it, for he ranks it first among,
those substances which do not spoil on the stomach. Of bread in general,
he correctly remarks, ^' Siquidem plus alimenti est in pane quam in ullo
alio.*' Pliny and Galen describe a soft spongy kind of bread, which would
seem to have resembled that which the common people in Scotland call
Bunns. Pliny adds, that some nations prepare their bread with butter. He
mentions a sort of bread called Artolagani, which, according to Dr. Arbuth-
not, answered to our Cakes. Seth gives an interesting account of bread;
but it is mostly extracted from Galen. Haly Abbas says, that the best kind
of bread is that which is made from wheaten flour and salt, and is fermented^
and heated in an oven to such a degree as not to burn the outer-crust. Rhasea
disapproves entirely of unleavened bread. Serapion states that old bread
is astringent. Avenzoar properly prefers newly-made bread, provided it has
been cooled. According to Actuarius, the lightest kinds of Wheat form the
best bread for indolent persons, but persons actively employed require the
weightiest kinds. Unleavened bread, he says, is very indigestible. Breads
prepared with oil, he adds, is very nutritious, but requires a strong stomach
to digest it. See an interesting account of the various kinds of bread in
Athenaeus, Deipnos, lib. ii.
The Zea, Typha, and Olyra of the Greeks, and the Far and Adoreum of
the Romans, were all varieties of Spelt, a species of grain bearing some re-
semblance to wheat. Actuarius calls it a lignt, and not very nutritious grain.
The Chondrus was prepared from Spelt, by first separating the husk, and
then breaking it down into granules. The Alica was the same as the Chon-
drus^ with only the addition of a small quantity of chalk ; and, indeed, al-
most all the writers on Dietetics, except our author, use them as synonymous
terms. A more complicated method of preparing them is described by Pliny,
COMMENTARY ON TUE FIRST BOOK. 101
N
and in tlie Geoponics, lib. iii.7. Sprengel says that Chondrus is called Perl*
graupen by the Germans. Galen, like our author, explains that a gruel, or de-
coction from it, is unwholesome, as it thickens before it is properly concocted.
Starch, according to Galen and Oribasius, is lubricant, and not calefacient
like bread. They say that it is not very nutritious. Serapion gives the same
account of it.
Galen, Hhases, Haly Abbas, and, in fact, 1 believe, all the authorities, agree
that Barley is of a colder nature, and less nutritions than wheat. Polenta was
prepared, by first steeping the grain in water, and afterwards drying it at the
fire, and grinding it down to meal. It was therefore a sort of malt. Galen,
like our author, remarks that Barley-meal sprinkled on wine and water, or
water alone, makes an excellent beverage. Actuarius recommends Barley
water as a diluent drink in Fevers. Ptisan of barley was thus prepared : —
Barley was boiled until it swelled; it was then dried in the sun, and af-
terwards pounded, and freed of its husk, and again pounded, but not ground.
This Flour was boiled with fifteen parts of water, to which a small quantity
of oil, and, when it swelled, some vinegar were added. Salt also was often
added to it. See Galen*s treatise de Ptisana. A long-lived race of people in
Chaldea are said to have subsisted principally upon Barley bread. V. Lu-
ciani Macrohii,
GaleD says of Oats that they are the food of horses and not of men. One
would almost fancy that Dr. Johnson bad stolen his definition of Oats from
him ! Aetlus and Simeon Seth call them refrigerant.
Galen, Dioscorides, Simeon Seth, and Serapion, agree that Rice is astrin-
gent, and recommend it for ulcers of the Intestines. Simeon Seth calls it
nutritioos.
Galen and Serapion say that Millet and Panic, being devoid of oily matter,
are desiccative, and therefore useful in defluxions of the belly. Simeon Seth
says that the Millet is of dilficnlt digestion, and not nutritious. Rhases di-
rects to eat Panic with fresh milk, butter, and sugar. Pliny mentions a sweet
species of Bread prepared from Millet. Galen says that it is not possessed
of much nourishment.
The Maza, as Zeunius explains it, consisted of the flour of toasted barley
ponnded with some liquor, such as water, oil, milk, oxycrate, oxymel, or
honied water. Galen calls it flatulent and unwholesome food. Hesiod re-
commends the Maza, or Cake prepared with milk, as an article of food during
the beat of the Dog-days. Opera et Dki, 1. 588.
The Bellaria, called also Placentte, Liba, and Crustulae, by the Romans,
and by the Greeks irffifmra and Irpia, were Cakes of various kinds, prepared
with flour, water, oil, honey, and sometimes fruits. See Athenseus, Deipnos.
xiv. The ObcUu$ panis, mentioned by him in the 3d Book, is supposed by
Ludovicus Nonnius to have been a species of Pastry.
The Bticellatum mentioned by Ammianus Marcellinus, and ^lius Sparti-
anus, was a species of Bread used by the Roman soldiers, anfi appears to
have resembled our Ship-Biscuit. V. Not. Oronovii ap. Amm. Marcell.
xvii, 8.
LXXIX. ON THE LBGUMINA, OR PULSE.
Rhases, and other of the ancient authors remark, that Pulse in general
are nutritious. All held that they are flatulent, excrementitious, and
aphrodisiacal. According to Plutarch, it was on account of their aphro-
disiacal qualities that the Egyptian priests forbade the use of them. Some
assign this as the reason why Pythagoras — " ventri indulsit non omne legu-
men." Apollonius Dyscolus says that he did so because they are flatulenf,
102 COMMBNTART ON THE FIRST BOOK.
difficult to digest, and occasion disturbed dreams. Hist. Mir(^, c. 46. Thi9
seems the most likely reason ; but Plutarch, Jamblichus, and Porphyry, think
they see more recondite meanings in the Pythagorean interdiction. Actuarius
remarks that all kinds of Pulse are to be eaten in their green juicy state.
Galen speaks of Lentils in much the same terms as Paulus. He particu-
larly disapproves of the practice, which he says was common in his time, of
eating them with sodden wine. Rhases says that they are of a cold, desiccaf>
five, and excrementitious nature. Actuarius calls them the worst of the Le-
gumina. Athenaeus mentions that the Egyptians lived much upon Lentils.
Lib. iv.
All the commentators are puzzled to determine what the ancient Faba was.
L am inclined to think, with Dickson, that Theophrasius's description of it
applies best to our small bean. The Egyptian Bean, according to Sprengel,
was the Nelumbium Speciosum, Galen mentions that Beans were much used
by the Gladiators for giving them Flesh, but adds that it was not firm or
compact. Dr. Cullen, by the way, notices the nutritious qualities of these
tilings, but omits to mention that the Flesh which they form is deficient
in firmness. Actuarius states that they are nutritious, but dissuaides from
using them freely^ because of theif flatulence. Acconling to Celsus, both
Beans and Lentils are stronger food than Pease. Seth agrees with Galen^
that the Flesh formed from them is flabby and soft. Galen directs to fry
Beans, or boil them with onions, whereby they will be rendered less flatulent.
De Alim. Facult. lib. i.
All the authorities give Pease much the same characters as I^uilus does.
Galeft mentions the method of steeping Chiches in water, and getting them
to germinate before using them for food. Are the bons vivans of the piesent
day acquainted with this method of making Pease tender and soft? The an*
cients were also in the practice of prepaiing these seeds for sowing in much
the same manner. Geopon. ii. 36. See also Pliny, xviii; c. 13. I am in-
clined to think that Virgil alludes to this practice, Georg. i. 193 ; but Dr.
Hunter has put a different interpretation on this passage. It would appear
that the modern Egyptians eat Beans in the sprouting state, that is to s^^.
when beginning to germinate. See Assalini on the Plague, p. 106.
Khases properly remarks that Lupines, being bitter, are not properly arti-
cles of food, but medicines. They possess^ he adds, little nutriment. Galen
says that they are indigestible, sma therefore apt to engender crude humours.
When eaten, he directs to have them well sweetened.
Galen mentions that some took Fenugreek, with Fish-sauce, to open the
belly. He says it may be eaten with vinegar, wine^ fish-sauce, or oil. Some^
he adds, use them as a condiment to bread. Rhases gives similar directions
for using Fenugreek.
It is probable that the Faseolus was the Kidney-bean. Harduincalte it
Feverole in French. Rhases says that Fasils are flatulent, and fiuten the
body. Pliny remarks that they are eaten with their husks* He idludes^ I
suppose, to the variety of them called Dolichi. Galen says that they are
more laxative and nutritious, but not so flatulent as Pease. Oribasins says
that they hold an intermediate place between those substances which give
much and those which afford little nourishment. Tares, as Cralen and Ori-
basius mention, were sometimes used for food during a famine.
Galen, likewise, makes mention of the Lathyrus and Aracus, two varieties
of the Chichling Vetch. He says they resemble in properties the Fasils.
In an ancient Proverb, preserved by Athenaus, it is said that "Figs are to
be eaten after fish, and Pulse after flesh."
COMMBNTART ON THE FIRST BOOK. 103
LXXX. ON THE FRUCTUS HORAI, OR SUMMER FRUITS.
Galen explains that the Fructus Honei are those fruits which grow up
ahoQt the middle of the Dog-days. He says that they all contain unwhol^
some jaices, which, if they spoil in the belly, are apt to become deleterious
poisons. Mnesitheus says that all these fruits supply little nourishment, but
that what they ^ive is of a humid nature, and does not disagree with the body.
Athenseus, l5etp, lib. i'i. Dr. Cullen describes them by the name of Acido'
dulcts Frficitu, Modem authorities agree with the ancient, that they are cool-
ing but indigestible.
The Gourd {koKokvvBtj), according to Galen, is the most innocent of this
class of limits ; and yet, when it spoils in the stomach, it engenders bad
juices. Diphilus, as quoted by Athenseus, says of it that it supplies little
nourishment, is apt to spoil, dilutes the system, is readily discharged, con-
tains good juices, and is more savoury when taken with water and vinegar,
but more wholesome when pickled. Apicius gives many receipts for cook-
ing Gourds. By one of these we are directed to eat them boiled, with pickle,
oil, and wine. Most of the other receipts contain a liberal allowance of
spioes and aromatics. Simeon Seth calls them digestible and wholesome,
but not nutritious.
The Pompion (ir«r»v), according to Galen, is juicy, detergent, diuretic,
and laxative. Seth recommends persons of a pituitous habit of body to drink
old wine with it, but such as are bilious to eat acid food. He remarks that
it is apt to excite nausea. Actuarius says that, when digested, Pompions form
a thin watery blood. Apicius directs to eat them and melons with pepper,
penny-royal, honey, or raisin wine, pickle, and vinegar ; to which assafietida
may be shaded. Hippocrates calls them laxative and diuretic, but flatulent.
Galen says of the Melopepon, or Squash, that its juices are not so unwhole-
some, nor so diuretic, nor so laxative, as those of the Pompion. He adds
that, although far from delicious, it is not so nauseous as the Pompion. On
the Melopepon, see Harduins's note on Pliny, H. N, xviii. 5. Perhaps some
of the authorities may have meant the Melon by the Melopepon. Ludovicus
Nonnius mentions that the Melopepones were a superior species of the
Pepones.
Galen says that some persons, from idiosyncrasy, readily digest the cucum-
ber ((rf«n;of) ; but he insists that it is impossible that good blood can be formed
from it, and therefore he warns against the frequent use of all such fruits.
Actuarius says that it forms a crude chyme, and is of a cold, humid, and in*
digsstible nature. Celsus says that its nutritive powers are feeble. Avicenna
says that its juices are bad, and prone to putrefaction.
Melcms are said by Averrhoes to be of a cold nature, juicy, detergent, and
diuretic.
Owing to the lax signification in which the word Cucumis is often taken by
the Roman, and o-iicuo^ by the Greek writers, I have felt considerable difficulty
in distinguishing the articles treated of in this chapter. I have been obliged for
once to abandon the guidance of Sprengel, but have done so with the greatest
hesitation, and not until I had compared the descriptions of all the Greek,
Latin, and Ajabian authorities. Schneider points out the confusion about the
use of these terms, but does not sufficiently clear it up. Index to Theophras-
ftts. Ludovicus Nonnius may likewise be consulted with advantage. He
supposes that the Pepones of the ancients were our Melons; and, as we have
slated above, he is also inclined to believe that the Melopepon was a species of
the same. De Re Cibaria, lib. i. c.l6. For want of a oetter term, 1 have
ventured to translate it the Squash, although I am uncertain whether the Greeks
^ere acquainted with this fruit, now so common in the East and in America.
104 COMMUNTARY ON THE FIRST fiOOK<
LXXXI. — ON THE FRUIT OP TREES.
It may be proper, in the first place, to discuss briefly the question re-
specting the proper time for eating fruit. Galen, Rhases, and Simeon Seth,
direct to eat fruit at the beginning of a regular meal. It appears, however,
to have been customary with the ancients, as it is in Britain at the present
day, to eat all manner of fruits at the mensa secunda, or Dessert, as we leara
fr(mi Athenxus and Macrobius. Horace was fond of concluding his banquets
with fruit. He speaks of finishing a frugal repast with hung grapes, nuts,-
and figs. Sat. ii. 2; and in another place he says —
" llle salubres
iEstates peraget, qtii nigris prandia moris
Fmiet ante gravem quae legerit arbore solem.'* — Sai, ii. 4.
1 may mention, by the way, that Galen, on the other hand, positively forbids
to eat mulberries after other food. But what Celsus says i-especting tlie
proper time for eating fruit is very much to the purpose : — " Secunda
mensa bono stomacho nihil nocet, in imbecillo coascescit. Si quis itaque
hocparuni valet, palmulas pomaque et similia primo cibo assumit." Lib. i. 2.
Modern authorities are as much divided in opinion upon this point as tlie an-
cient were. Dr. Cullen maintained that the proper time for eating fruit is at
the conclusion of Dinner. Mr. Abernethy, on the other hand, when laying
down directions about the Diet of Dyspeptics, recommends to take fruit ra-
ther before than after dinner. Van Swieten, in like manner, when treating
of the Fructus Hora^ i, forbids to eat them after dinner. Dr. Paris inclines to
the same opinion. He says that ** the proper seasons for taking fruit are the
morning and evening. On some occasions it may be taken with advantage
at breakfast, or three hours before dinner ; and it affords a light and agreeable
repast if taken an hour before bed-time.*' My own sentiments on this sub-
ject accord pretty nearly with the opinion of Celsus. I would say thai much
fruit ought not to be taken at the conclusion of dinner, especially by persons
having weak stomachs, but that the practice of eating a small quantity at the
Dessert does no harm in general. Ludovicus Nonnius recommends to eat
the summer fruits, and Cherries, Strawberries, Plums, Peaches, and the like,
at the beginning ; but Apples, Pears, Nuts, Chesnuts, and the like, at the'
conclusion of a meal, that is to say, at the Dessert.
Tlie Fig was a great favourite with the ancients. Galen states that it is
decidedly nutritious, but that the flesh formed from it is not firm and com-
pact like that from pork and bread, but soft and spongy like that from Beans.
Ue says that Figs increase the urinary and alvine discharges. Averrboes says
that they are of a hot and humid temperament, and that they loosen the belly
and strengthen the stomach. See, m particular, Athenseus, Deip. lib. iii.
Macrobius, Satur. iii. 20. and Haly Abbas. Haly says that the Fig is the
most digestible, nutritious, and wholesome fruit of this class. Galen speaks
doubtfully of dried Figs.
My limits will scarcely admit of my touching upon the culture of the Grape
and its properties, as a medicine and article of food. Pliny devotes a whole
book to the consideration of the Grape and its productions. Galen says
that, like Figs, Grapes are nutritious, but that the flesh formed from them is
deficient in firmness and durability. He remarks that their stones pass
through the bowels wholly unchanged. Simeon Seth states that the Grape
<onsists of four different substances, namely, the membrane which surrounds
it, the fleshy part, the juice, and the stones. Of these, he says, the outer coat
and the stones ought lobe rejected, because they are indigestible. Plutarch
and Macrobius exert their ingenuity to explain how it happens that must, or
COMMENTART ON TUB F1E8T BOOK.
105
the fresh juice of the Grape, does not intoxicate like wine. *'Tlie Pensilis
uva," or hung Grape, is mentioned by Horace as an article of the Dessert.
Lib. ii. Sat. 2.
Galen gives Mulberries the same character as our author does. Aetius
^ys that the proper occasion for them is when the stomach is hot and dry»
According to Athensus, the Siphnian Diphilus said that they possess mode-
rately wholesome juices, and that they afford little nourisliment, but are sa-
voury, and of easy evacuation. Haly Abbas recommends them cooled in
snow for heat of the stomach.
According to Pliny, Cherries were first imported to Italy from Pontus, by
the famous Luculius. This story, however, is not very probable, as they had
been described more than a century before by Theophrastus. Athenseus
mentions further that they bad been noticed, long before LucuUus, by the
Siphnian Diphilus. Simeon Seth says that they are of a cold and humid
nature, and open the bowels. They are useful, he adds, when the stomach
and constitution are hot and dry.
Galen states that the fruit of the Pine contains thick and wholesome juices,
but that tliey are not easily digested. The Siphnian Diphilus, as quoted by
Atbenseus, says that the Strobili are very nutritious, smooth asperities of the
Trachea, and purge the breast. MnesiUieus, as quoted by the same author,
says that they fatten the body, and do not impair the digestion. Deipn. lib.
ii. Celsus holds them to be stomachic.
Our author's remarks on the Persica are taken from Galen. Seth calls
them Rhodacina. He says that they are cooling, diluent, and laxative, but
difficult to digest. If not the same as the modem Peach (which the com-
mentators suspect), the Persica was evidently a fruit nearly allied to it.
It is highly probable, but not quite certain, that the Prsecocia, Duracina,
and Armeniaca were varieties of the Apricot. Galen does not use the
second of these terms, and mentions, that many held the first and the last to
be exactly the same fruit ; and he, himself, in another place, forgets the dis-
tinction which be had endeavoured to establish between them. Simeon Seth
describes them by the name of fitpiKOKKo, which appears to be a corruption of
the Latin Praecocia. — (See Geopon. x. 73, and the note of Needham — Har-
doin's note on Pliny — Ludovicus Nonnius, u. s, and Sprengel, Dio$cor. i. 165.)
Seth says that they are firuits which soon spoil, and form bad blood.
Idala was used by the ancients as a generic term, comprehending many
species of firuit. See an interesting account of them in Pliny, xxiii. 5. Ma-
crobius, Saturn, iii. 19. and Athensus, Deipn. lib. iii. Diphilus thus
states their general characters as articles of food : ** Green and unripe
Apples are unwholesome and unsavoury, swim in the stomach, form bile,
and occasion diseases. Of the ripe, such as are sweet are more wholesome
and more laxative from having no astringency : the acid are more unwhole-
some and constipating, but such as have also a certain degree of sweetness,
become more delicious, and are at the s^me time stomachic from having
some astringency/' The ancients appear to have been well acquainted with
ihe methods of making Cider, Perry, and the like. See Macrobius, Sat, vii.
6. and Plin. H, N, xiv. 19. The Arabian authors in general speak rather
unfavourably of Apples.
The Cydonia or Quinces were in great repute, not only as articles of food,
but as medicines. When unripe they are very astringent and contain much
acid, and hence they were used in such cases as those in which the mineral
acids are now generally administered. Plinius, H, N. xxxiii. 6. They ap-
pear to be the *^ cana maW of Virgil. Columella and Pliny describe three
species, namely the Chrysoroala, Struthea, and Mustea.
iPears, according to Simeon Seth, are of a cold and desiccative nature.
They are compounded, he says, of astringency, sweetness, and sometimes of
106 COMMENTART ON THE FIRST BOOK.
acidity; and some have a moderate degree of heating and desiccaiive pro-
perties. Averrhoes gives exactly the same account of them. Of Pomegra-
nates, he says, that some are sweet and some are acid : that all of them
moisten, but that the sweet are of a more hot and humid nature. Homer
enumerates Pomegranates among the fruits which were suspended over the
head of Tantalus to tempt his appetite. Dioscoddes says, that the sweet
Pomegranates are stomactiic; but are prejudicial when there is fever.
Galen, who gives Medlars and Services much the same characters as our
author, recommends to take them only in very small quantities. Aetius and
Seth say that ripe Medlars are somewhat heating, but that the unripe are
cold, astringent, and constipating. Actuarius calls them excellent astringent
medicines, but bad articles of food. Dioscorides describes two species of
Medlars, the Aronia, and Setanium. The first species is called AzaroUo by
the Italians; the oAer is the common species of Medlar.
See an interesting account of Dates, or the fruit of the Palm-tree, in the
Hierobotanicon of Olaus Celsius. The Date, according to Galen, is a frait
possessing a variety of characters, but having always a certain degree of
sweetness and astringency. He says, it is indigestible and apt to occasion
headachs. Simeon Seth says that Dates form an impure blooa ; and Rufius,
as quoted by him, affirms that they prove injurious to the bladder. Serapion,
Rhases, and Mesne agree that tibe Date is a cold astringent fruit. Hero-
dotus, Xenophon, and Athensus make mention of a wine prepared from
Dates. Erotian s^s, that a species of bread is made from Dates, flour, and
water. Lexicon Hippocratis.
The Olive, as Pliny remarks, consists of four parts, the kernel, the oil, the
flesh, and the lees. The Drupse, mentioned by our author, were the Olives
quite ripe and ready to fidl from the tree. The Colymbades and Halmades
were Olives pickled with salt, &c. See Harduin, ap, Plin, H, N. xv. 3.
The Siphnian Diphilus, as quoted by Atheneeus, says of them that they
supply little nourishment, occasion headachs ; that the black injure the sto-
macn, and bring on heaviness of the head ; and that the pickled prove more
stomachic and astringent of the belly. Galen mentions, that Olives were
often eaten with bread before dinner in order to open the belly. Simeon
Seth says that ripe Olives are moderately hot, but tnat the unripe are cold^
desiccative, and astringent. Serapion, in like manner, says that unripe
Olives are astringent. Plutarch mentions a pickled Olive as a whetter of
the appetite. Synop. lib. vi.
The Siphnian Diphilus, as quoted by Athenseus, states, that Walnuts oc-
casion headach, and swim on the stomach ; but such as are tender and white
contain better juices, and are more wholesome ; and that such as have been
toasted in a furnace aflbrd little nourishment. Deipn. lib. ii. It appears
from Macrobius, whose account of them is very interesting, that they were
eaten at the dessert. He states decidedly that, the Rojral Nut of the Greeks
was the Juglans or Walnut. Sat, iii. 18. Simeon Seth says that, when taken
before other food, they are apt to prove laxative or emetic. Averrhoes says
the like of them. He adds, that Filberts are not so apt to produce this
efiect. According to Rhases, they are apt to prove injurious to the stomach
and liver.
The Siphnian Diphilus says, that Almonds are attenuant, diuretic, purga-
tive, and afibrd little nourishment ; that the green contain bad juices, and
are possessed of stronger medicinal properties ; but that the drieo are more
flatulent, and apter to swim on the stomach. He adds, that such as are
tender, flill, and are whitened, contain milky juices which are more whole-
some. Simeon Seth says, that bitter Almonds are hotter, more attenuant,
and more incisive than the ripe. He adds, that Filberts are the most nutri-
tious of the puts but difficult to digest.
COMMXNTART ON TUX FIRST BOOK. 107
The Pistachio nut is very celebrated in ihe East and in Sicily. See Ol.
Celsii. Hierobotanicony and Brydone*s Tour through Sicily. Galen says,
that it possesses a certain degree of bitterness and astringency, and that it
proves useful in obstructions of the liver, but that it affords little nourish-
ment. He adds, that it is neither beneficial nor injurious to the stomach.
Simeon Setli remarks, that the modems looked upon Pistacs as stomachic.
Averrhoet speaks highly of them. Rhases says they are of a hotter na-
ture than Almonds. Theophrastus describes the Pistachio tree as a species
of Turpentine, and it is now acknowledged as such.
Galen states that the best Damescenes are such as are large, spongy, and
astringent. He adds, that taken with sweet wine they tend to open the
bowels. Oribasius says that they afford little nourishment, but may be
useful for moistening and cooling the stomach. Martial calls them laxative.
It appears certain from Isidorus, that the Coccimela and Myz» were the
same as the Pruna or Plums.
Galen says of Jujubes, that they suit best with the intemperaments of
women and children. Haly Abbas states that they are cold and humid, of
slow digestion^ and apt to form phlegm.
Abu'l-fedli, as quoted by Glaus Celsius, says, of the Siliquie or Carobs,
that they are sweet astringent fruit Horace speaks of them as being an inie*
nor kind of fruit. *' Vivit siliquis et pane secundo,'' Ep. ii. 1 . And so,
also^ Juvenal, Sat. xi. 59. and Persius, iii. 55. Galen says of them, that
they are woody and consequently indigestible. Aetius says, that they are of
a dry and very desiccative nature, but possess some sweetness. Pliny men-
tions that a sort of wine was prepared from Carobs.
Ckilen says that the SycanK>res hold an intermediate place between Mul-
berries and Figs. He says, further, that they are sweetish, and of a diluent
and cooling nature. Dioscorides and Serapion speak unfavourably of them
as hemg articles ofiood which are only used in times of famine.
The Citron^ or *' Felix Malum" of Virgil, was greatly esteemed by the an-
cients. Galen calls it fragrant, aromatic, and pleasant to the taste as well as
the smell. From Theophrastus downwards, it is much celebrated as an anti-
dote to poisons. See some curious information respecting it in Athomus,
De^jm* lib. iii. and Macrobius, Sat. iii. 19. Simeon Seth says, that if
taken in moderation it is beneficial to the stomach, but that in large quantity
it proves indigestible. Serapion recommends after eating Citrons to take of
anise, mastich, and wine.
Gaden says, in general, of the wild kinds of fruit, that they supply little
nourishment, and that they are injurious to the stomach. The Acorns, ht
says further, are the best of this class, being no less nutritious than the Ce-
lealia ; lie adds, that in ancient times men lived upon Acorns ; and
that the Arcadians continued this practice, after the Cerealia were used in all
the other parts of Greece. Simeon Seth says that, although nutritious, they
aie difficiut to digest and form crude humours : and hence he recommends to
abstain from them.
Galen's opinion of Chesnuts agrees with the account given by our author
of them. Simeon Seth says, that they are very nutritious, but are hard to
digest and evacuate from the body ; and that they are flatulent and astrin-
gent Haly Abbas describes them as a proper article of food. At the pre-
sent day, whole nations of mankind live upon Chesnuts. The opinion of
Mnisitheus regarding them, as quoted by Athenaeus, appears to be very judi-
cious; he says, they are difficult to digest and flatulent, but sufficiently
nutritious if digested.
The Strawberries, or Fraga, are mentioned by Virgil, ( Eel. iii.) and Ovid.
(Metam. i.) but they are wholly unnoticed by the Greek writers.
108 COMMENTARY ON THE FIRST BOOK.
LXXXII. ON ANIMALS, AND« FIRST, OF FOWLS.
Hippocrates states, that Fowls in general are drier than quadrupeds.
The driest, he adds, are, first, the Wood-pigeon, then the common Pigeon,
and, thirdly, the Partridge, Cock, and Turtle. The most humid or juicy, he
says, are Geese. Those which live on seeds are drier than the others. The
flesh of Ducks, and of all Fowls which live in marshes, or in water, is of a
more humid nature. De DiatUy ii. 17. In another place, he calls the flesh
or Fowls one of the lightest kinds of food. De Affectianibus, c. 46.
Their general characters are thus stated by Celsus : ** £x iis avibus, quie
in media specie sunt, valentiores eee, quse pedibus, quam qus volatu magis
nituntur : et ex iis, quse volatu fidunt, firmiores qus grandiores aves, quam
quae minutse sunt ; ut ficedula et turdus. Atque e% quoque qus in aqua degunt
leviorem cibum prsstant, quam qus natandi scientiam'non habent.'' The cha-
racter here given of Water Fowls has drawn upon the author the animadversions
of Dr. Cullen. But rather than suspect Celsus of such a mistake, I am inclined
to believe that the text must be corrupt, and that we ought to read graviorem
instead of leviorem. I am confirmed in this conjecture from all the other au-
thorities, as for example, Hippocrates, Galen, Aetius, Rhases, and Ualy
Abbas, having stated that the flesh of Water Fowls is more ezcrementitious
than that of Land Fowls. If this be reckoned too bold an alteration, might
we not substitute leniorem ?
Our author takes his account of Fowls from Galen, or perhaps direct from
Oribasius. Actuarius states, that Fowls are much lighter, but not so nutri-
tious as quadrupeds ; that they are drier, more fibrous, and form thinner
blood ; and that Water Fowls are the more juicy and fleshy.
Having thus stated the general characters of Fowls as articles of iood, we
shall now briefly notice a few of those which were in most esteem with the
tons vivans of antiquity.
The Partridge was accounted a rare delicacy at the tables of luxurious
Romans. See Martial, Xenia^ Ixi. Simeon Seth says that it is easily digested,
hxki ought not to be eaten the day it is killed. According to Rhases, it con-
tains thick juices, is astringent, but very nutritious. Apicius directs to dress
it with pepper, lovage, mint, the seed of rue, pickle, wine, and oil.
Galen ranks the Pigeon next to the Partridge in excellence. The Arabians^
however, and, in imitation of them, Simeon Seth, call the flesh of the Pigeon
heating and excrementitious.
The Attagen lonicus has been celebrated by the muses of Horace and
Martial. Porphyrion, one of the ancient commentators on Horace, calls it
'* avis Asiatica inter nobilissimas habita.^ Harduin, who is deservedly
reckoned a high authority in these matters, supposes it to have been the
Gelinotte du hois, or Wood-hen, Atheneus quotes Aristophanes as calling
it a most delicious bird. Galen, Aetius, and Oribasius speak of it in the
same terms as Paulus. Apicius directs to dress it like the Partridge.
Persius speaks of the Thrush as being a much-esteemed delicacy. Sat, vi.
Horace also says, that there is nothing better than a fat Thrush. Kpi$U i. 1 5.
See Aristoph. Nubes, Athensus, Deipn, lib. ii. It is worthy of remark^
that, although the Thrush be by no means a delicate morsel in the North
of Europe, it is very delicious in Italy and Spain. It feeds on juniper ber^
ries, grapes, and the like. The Receipts of Apicius for dressing Thrushes,
and other small birds, contain spices, aromatics, honey, wine, pickle, and
oil. Averrhoes says that their flesh is drier, more aromatic, but gi-osser than
that of Pigeons. The Romans bestowed great pains upon feeding Thrushes,
as we can learn from \^arro and Columella. They also ate Blackbirds and
Larks.
COMMENTARY ON THE FIRST BOOK. 109
Martial intimates that, wlien he could get a fat Turtle to dine upon, he was
indifferent about other delicacies. According to Averrlioes, it is of a hot
nature, and has a wonderful effect in sharpening the understanding. Apicius
directs to dress it like the Partridge. Galen states, that the Turtle, Partridge,
and all fowls which are of a dry nature, should be suspended for a day before
they are eaten.
Galen mentions that the flesh of Pheasants resembles that of domestic hens,
but is more nutritious and savoury. Simeon Seth says that it is wholesome,
easily digested, and forms good blood. The Tetrao, which is mentioned by
Pliny and Athensus, is generally supposed to be the Bustard ; but Bellonius
and Ladovicus Nonnius take it for the Fasiano net^ro of the Italians, or tlie
Wood Pheasant.
Galen and oar author have omitted to take notice of Quails. Simeon Seth
says, that their flesh is heating, coarse, indigestible, and unwholesome.
RbaseSy however, says of the Quail, that in lightness it is second only to
the Starling; that it is not very excrementitious, nor accounted very heating.
Averrfaoes says, that it is of a moderate temperament, but somewhat heating;
that it is delicate, forms good chyme, and is excellent food for persons in good
health and for convalescents. Lucretius and Galen mention that the Quail
can live upon Hellebore.
Q. Ilortensius is ^ damned to everlasting fame*' for having first presented
the Peacock at his table. Varro, de AgricuU, lib. iii. Macrobius, Saiur.
iii. 13. Plinius, H, N. x. 20. iElianus, U. A. v. 25. Tertullianus, de Pallio.
It came afterwajrds to be thought an exquisite delicacy, although Horace had
declared of it that, were it not for its price, it would not be thought superior
to the common domestic fowl. Sat. ii. 2. Simeon Seth, like Galen and our
author, says that its flesh is indigestible and excrementitious. Apicius di-
rects to dress it like the Thrush. The poet, Juvenal, asserts that sudden
deaths are occasioned by the indigestion arising from eating Peacocks. Sat, 1.
The Ostrich is often mentioned by the ancient authors as an article of food,
although, as Galen says, it be excrementitious and indigestible. The ^ Afra
avis," mentioned by llorace, is said by his commentator, Acron, to have been
the Ostrich. Porphyrion, however, rather supposes it to be the Gallina Nu-
medica, or Guinea Hen, Apicius directs to dress it with pepper, lovage,
thyme or savoury, honey, mustard, vinegar, pickle, and oil. Khases says
that its flesh is very coarse.
Schneider makes the Otis to be the Tarda, or Bustard. Xenophon, who
^ves a most graphic description of the mode of hunting it in Persia, says
that its flesh is most delicious. Galen and Simeon Seth say that its flesh is
intermediate between the Goose and the Crane. Apicius gives very compli-
cated receipts for dressing it.
The flesh of the domestic fowls, says Simeon Seth, is of easy digestion,
^od contains good juices, especially the flesh of those which are beginning to
lay eggs. Chickens, he adds, are of easy digestion, and form blood of mo-
derate consistence, neither very thin nor too thick : they are excellent fqod
for persons who do not take strong exercise. It appears, from Martial, that
the Homans were fond of Capons. Lib. xiii.
The Gailinago minor is held by Ludovicus Nonnius to be the Snipe. The
Callinago major, or 2Ko\wir<i^ of Aristotle, he supposes to be the Beccasa or
^Vood•cock. It is well described in a fragment of the poet Nemesianus.
The Ficedula, called avicakis by Aristotle, was much sought afler by the
B^maos. Ludovicus Nonnius supposes it to be the Beccafigo of the modem
Italians, who are still very fond of it. Its flesh being lat, it was dressed
with much pepper, as we learn from Martial and Petronius Arbiter.
Galen and Simeon Seth agree that the flesh of Geese is indigestible and
^icrementttious, ^nd therefore nearly allied to the Ostrich.
110 COMMKNTART ON THB FIRST BOOK.
According to Martial, the breast and neck are the only parts of tiie Duck
which are fit to be eaten.
Athenaeus mentions that the Swan was sometimes brought to the table. —
Deipnos, lib. ix. Its flesh is very hard.
LXXXIII. — ON BOGS.
Our author, Ohbasius, and Aetius, copy their account of Eggs from
Galen.
Hippocrates says that they are nutritious, strengthening, and flatulent. —
See also Celsus, ii. 18.
See a curious account of the medicinal properties of Eggs in Plinii H.
N, xxix. 3.
Rhases recommends to eat Eggs in a soft state with pepper and marjoram.
Cont. xxxiii. He says that the best Eggs are those of the hen and partridge,
and next to them those of the duck. Those of geese, he says, should not be
eaten. Ad, Maruor. iii. 13.
The ancients preserved their eggs in the flour of beans, chaff, or bran. —
Plinius, H, N,x, 61. Columella, viii. 6. Varro, de Re Biutkoy iii. 9.
Pliny mentions that, if an Egg be macerated in vinegar, it will become so
soft Uiat it may be drawn through a ring without breaking. Harduin says,
that he had verified the truth of this &ict by experiment.
Horace affirms that Eggs of an oblong shape are the best :
** Longa <]pibus fades ovis erit, ilia memento
Ut succi melioris et ut magis alma rotundis
Ponere." Sat. lib. ii. 4.
I have here adopted the emendation of Dr. Bentley. The commentator,
Acron, however, read alba, but took it in the same sense as alma.
The ancients used to begin their banquets with Eggs, and hence the ex-
pression '' ab ovo ad malum,'' that is to say, from beginning to end of a
Danquet.
Galen and Simeon Seth agree that Eggs which are boiled hard, or which
have been roasted in ashes until thev are hard, become indigestible, and
supply heavy nourishment to the body ; but such as have been fried they
more especially condemn. When boiled to such a consistence as that the
white was just beginning to coagulate, they were called Tremula. When
so soft that the albumen was not at all coagulated, they were called Sorbilia.
In both these states, they are much approved of by Galen, Seth, and all the
authorities.
LXXXIV. — ON BBASTS.
Athemjeus remarks that the flesh of beasts, especially Oxen, fonned the
principal part of men's food in the heroic ages, as appears from Hom«r.
rrom one passage in the Iliad, (lib. xxiv. 1. 263.) and another in the Odyssey,
(lib. ix. 220.) it may be reasonably conjectured that they also lived upon
bmbs and kids, Deipn. i. 19. I may add, that Sophocles represents Phi-
loctetes as living, while in Lemnus, upon the birds which he killed with his
fatal bow. It is generally supposed that Pythagoras interdicted his disciples
entirely from the flesh of animals; but the truth of the matter seems to be,
that he recommended a spare use of it, and allowed to eat such animab only
as were used for sacrifices. See lamblichus and Porphyrins, de Vita Fy^
thagora. Plutarch, in two treatises, discusses the propriety of eating fleah.
COMMBNTART ON TUB FIRST BOOK. HI
Hippocrates states the particular characters of the diflere ut kinds of flesh
very correctly. He remarks^ that the flesh of wild animals is lighter than
that of domesticated.
The general remarks of Celsus may best be given in his own words : —
" Quadrupes omne animal, si lactens est, minus alimenti prsstat. Omne
etiam ferum animal domestico levius ; et quodcunque humido coelo, quam
quod sicco natum est. Delude eadem omnia pinguia, quam macra ; recentia
quam salsa ; nova quam vetusta, plus alimenti habent. Turn res eadem
magis alit jurulenta, quam assa; magis assa, quam elixa.''
Galen remarks, that the fleshy parts of quadrupeds form the best blood.
When boiled, he says, it supplies the body with more juicy, and when
roasted, with drier food. The temperament of domesticated animals, he
adds, is more humid or juicy than that of wild, owing to the dampness of
the atmosphere in which they live, and their inactivity. For, wild animals
among the mountains, being exposed to privations and fatigue, their flesh is
drier, contains no ia^ and is less disposed to putre&ction than the flesh of
domesticated animals. He states, that of all animals, whether fowls or beasts,
the flesh of such as are growing is better than those which are past their ut-
most gprowth ; that such as are at their growth hold an intermediate charac-
ter; but that the flesh of such as are very young or old is bad, because, in the
latter case, it is hard, dry, and fibrous, whence it is difficult to digest, and
not nutritious ; while, on the other hand, the bodies of very young animals,
being mucous (gelatinous?) watery, and therefore excrementitious, readily
pass through the bowels undigested.
Actuarius states, that animals which lead an indolent life are more humid
and excrementitious; whereas such as are much exercised are drier and
lighter. Upon the whole, he adds, the more the colour of flesh declines firom
white, the farther is it removed from wholesomeness. It is also to be known,
that wild animals are hotter and drier than domesticated.
Haly Abbas says, that the flesh of all animals is heating and humid, forms
much blood, and is nutritious. Avicenna remarks, that flesh strengthens the
body, and is readily converted into blood. According to Rhases, flesh is
the most nutritious of all aliments, and disposes most to plethora; hence,
those who live much upon it, require frequent venesection, especially if at
the same time given to drinking wine.
It may now be interesting to compare the opinion of Dr. Cullen with those
of the ancients on this subject. He lays it down as an ascertained rule,
Aat quadrupeds give, in the same proportion taken, more nourishment than
any vegetable aliments whatever. The latter, he says, are not like the former,
entirely convertible in tuccum et sanguinem. At the same time, he thinks
that animal food is less perspirable.
Of all idnds of animal food, Pork was almost universally esteemed by the an-
eieats as the best. Hippocrates repeatedly speaks of it as being most wholesome
and nutritious, and Galen says the same of it in the strongest language. He
states that the athletae, if for one day presented with the same bulk of any
other article of food, immediately experienced a diminution of strength ; and
if the change of diet was persisted in for several successive days, that they
fell off in flesh. He adds, that he had been credibly informed by persons
^0 had been compelled, under extraordinary circumstances, to taste human
flesh, that pork bears a near resemblance to it. Celsus praises it for its
lightness : '' Inter domesticas vero quadrupedes, levissima suilla est." Aetius,
Oribasius, and, in a word, all the Greek authorities subsequent to Gralen,
deliver exactly the same character of it as he. See, in particular, Simeon
Sedi. He says, that the flesh of swine a year old is the best, and that very
yoongpigs are not to be eaten, as being too humid and excrementitious. He
adds, tnat the flesh of wild boars furnish the best food, being neither so ex-
112 COMMENTARY ON THE FIRST BOOK.
crementitious nor so viscid as that of tame swine. The Arabian authors,
liowever, display some oriental prejudices against the flesh of swine. Avi-
cenna merely remarks of it that the Christians, and those who imitate them,
say that the flesh of the wild boar is the best of all. Averrhoes refers to the
opinion of Avicenna. Rhases, who has treated of Dietetics in three distinct
works, has nowhere, so far as I can discover, recommended pork as an
article of food. Haly Abbas, however, speaks favourably of it. He, I be-
lieve, was a Christian. Various receipts for dressing pork are ^ven by
Apicius. As a sauce for the flesh of the wild boar, he recommends a compo-
sition of honey, pickle, sodden wine, and raisin wine. Cato, the censor,gives
▼ery sensible directions for the preparation of Ham. De Re Rustica. c. 162.
It will be perceived that our author states that pork is imperspirable. Sane-
torius confirms the truth of this statement. Both Cicero and Porphyry quote
the saying of Chrysippus, that a sovl or living principle was given to swine,
as a sort of salt, to preserve their flesh from putrefaction for the use of man.
Mutton was no great favourite with the ancients. Galen, Aetius, Oribasius,
and Simeon Seth, agree with our author, that it is inferior to pork, as being
more excrementitious, and containing worse juices. Averrhoes, however, ac-
cuses Galen of being prejudiced against the flesh of wethers and lambs,
which, he afiirms, are inferior only to kids in excellence. Rhases, in like
manner, ranks mutton as second only to kid. Sedi savs, that the best rout-
ton is that of a sheep a year old. Apicius gives full directions for cooking
mutton and lamb. Lib. viii. It appears that, even at the present day, mut-
ton is by no means in so much request in Italy as it is in Britain, France,
and Germany. The Americans also are less fond of it than we in Britain
are.
All the ancient authorities speak of Goats' flesh in much the same terms as
our author; namely, as being acrid, and containing unwholesome juices.
That of buck-goats is said by Galen to be particularly bad ; and, next to it,
those of rams and of bulls. Of kid, he speaks favourably, as being next in
excellence to pork ; then he ranks veal. But lamb, he says, is humid, gela-
tinous and mucous. Rhases and Averrhoes rank kid first, and then lamb.
The poet Hesiod recommends kid as a delicious article of food during the
heat of Summer. Op. et Dies^ I. 590.
The Arabians mention Uie Gazelle (Dorcas) as being nearly allied to, but
superior to the goat. Simeon Seth says, that the flesh of the Dorcas is better
than that of any other wild animal, and that it is allied to the human body.
Hippocrates calls Beef a strong, astringent, and indigestible article of food.
Celsus ranks it among the articles which are not apt to spoil in the stomach.
Oribasius says, that it is more than moderately nutritious, but imperspirable,
and forms thick blood. Like Galen and our author, he savs, that it proves
injurious to those who are subject to collections of black bile. Seth sajrs,
that it is difiicult of digestion and distribution, but when digested, sufficiently
nutritious. Rhases says, that it supplies much nourishment of a gross nature,
and forms thick blood. Averrhoes says, that the flesh'of heifers is good, not
being so viscid, cold, and dry as the flesh of oxen. The sauces recommended
by Apicius for the flesh of oxen and heifers contain various spices, and
aromatics with vinegar, pickle, and oil.
The Glis or Dormouse is mentioned as a favourite delicacy of the Romans
by Varro, Pliny, Martial, Galen, and Ammianus Marcellinus.
All the authorities agree that the flesh of the Stag or Roe is difficult to
digest. Hence Rhases forbids to eat it, except after hard exercise. Simeon
Seth adds, that, as in Summer, stags frequently eat poisonous serpents, it
may be dangerous to take of their flesh at that season. Celsus appears to
have had a more favourable opinion of venison than most of the ancient au-
tliorities, for he ranks ^' omnis venatio'' among the things which agree best
COMMINTAET ON THK f lEST BOOK. 1 IS
with the stomach. Seth lays^ that Hare is sufficiently nutritious, if properly
digested, but that it disagrees with persons of a dry temperament, and is apt
to form melancholic humours. Apicius gives many complicated receipts
for dressing Hares. Pliny remarks, that there never is any fat on Hares.
H. N. xi. 85. Hippocrates says, that their flesh is dry and astringent.
Horace freqnenthr praises the shoulder of the Hare. In our days, the loins
are preferred. The Cnniculus, or Rabbit, was greatly esteemed in Spain, bm
does not appear to have been much used by the Greeks or Romans.
From the experiments of Sir Astley Cooper, it is ascertained, that the
solnbilit^ of animal food is in the order of pork, mutton, veal, and beef. This
account is little different from the ancient ctiaracters of them.
LXXXV.— ON TBB PARTS OF ANIMALS.
Since our author has stated very distinctly the characters of the parts of ani-
mals (haying abridged the fuller account of Galen), it will serve no purpose
for me to enlarge upon evenr one of these articles ; and, therefore, I shall
be content with makinff a few cursory remarks. For further information,
see Galenas, de AUm. Factdt, and de Euchym, — Oribasius, Med, Coll. lib.
v.^Aetins, lib. ii. — Rhases, ad Mamor. iii. 11. — Ilaly Ablms, Theor. v. 22.
—Serapion, de Simnl, ex AnimaL
Galen remarks, mat, as some rendered the liver of Swine sweet, by feeding
fliem upon dried figs, so he knew sonie persons who were in the practice of
preparing the livers of Geese in like manner, by feeding them upon milk, by
which means they were rendered not only delicious, but also very nutritious,
wholesome, digestible, and not difficult to evacuate. Oribasius and Haly
Abbes 8p€»k of it in much the same terms; but Haly adds, that much
of it ought not to be eaten at once, as it is slowly digested . Athenaeus speaks
of it as a delicacy in great request at Rome. Deipn, lib. viii. The liver of
a white goose red upon fotty figs is one of the delicacies mentioned by
Horace as having been presented at the supper of Nasiedenus. Sat. lib. ii.
8. 8. — See also JuTenat, v. 114. and Persius, vi. 7. If we may believe
Martial, tbe liver, in these cases, sometimes grew to such a size, as to surpass
the bod? of the animal. Epigr^ xiii. 58. We are informed by Pliny, that
it was dispnted to whom die Culinary art was indebted for the discovery of
thu exquisite delicacy. H,N,x.2\. Dr. Kitchiner, the modem Apicius,
says of It, " Although the liver is rather too luscious for the lingual nerves of
tbe good folks of Great Britain, the livers of poultry are considered a very
high rdish by our Continental neighbours." — took's Oracle, p. 181.
Galen states, that all fat and suet are of an oily nature, and that they ought
nAier to be used as condiments than as articles of food. Serapion gives the
Biost circumstantial account of the qualities of these animal oils.
The Vulva or Womb of a Sow, was esteemed an exquisite delicacy by the
Romans. There were three kinds of it — that is to say, it was taken in three
different states of the animal. The first, called Ejectitia, was procured by
forcing the animal to part vrith its young. The second, or Porcaria, was the
womb of the animal, taken after it had littered. The third, called Sterilis,
ivas the womb of a sow that had never been with young. This last is ranked
^ C^us among those things which are useful to the stomach. — See Plut-
aichus, de Etu Camiitm. Plinius, H. N. xi. 37. Simeon Seth, however,
<ioiidem8 it as indigestible. V, Not. Bogdani,
] 14 COMMBNTART ON THB FIRST ROOK.
LXXXVI. — ON MILK.
It appears from Homer, that the milk of various animals was used for
food in the heroic ages of Greece. His commentator, Eustathius^ remarks,
that it is very nutritious, and, in proof of this, relates the case of one Phi-
linus, who used no other food or drink. — Ap. Iliad, xiii. 6.
Hippocrates, who often makes mention of milk as a medicine, and as an
article of food, states, that it sometimes occasions the formation of stones in
the bladder (de AeribuSy Loci$, et Aqui$, c. 24); and this opinion was
adopted by all the ancient authorities on medicine; but, whether tnere be any
foundation for it or not, I cannot take upon myself to determine. Certain
it is, however, that children and young persons, who live mostly upon milk,
are very subject to Calculus ; and in the country, where milk is a common
article of food, the complaint is of frequent occurrence, whereas there is sel-
dom an instance of it at sea, where the diet must necessarily be very different.
According to Galen, the thickest milk of all, and the fattest, is that of Cows ;
the most liquid and least fat, is that of the Camel ; and after it that of the
Mare, and then of the Ass ; the milk of Goats is of a middle consistenoey
and that of Sheep thicker than it. It is clear, he adds, that thick milk coa-
tains more cheese, and liquid more whey. Liquid milk, therefore, is more
laxative than thick ; and, on the contrary, thick milk is more natritious than
liquid. He mentions, that whey, either alone or with a certain mixture of
salt, may often be used as an excellent laxative medicine. He states, that, if a
Goat or any other animal eat of scammony or spurge, her milk will be ren-
dered purgative. He says, that milk is most beneficial in complaints of the
chest, but most injurious in diseases of the head and hypochoodrium. Ht,
and all the ancient authorities after him , state, that milk is apt to hurt the teeth.
Celsus calls milk a wholesome and nutritious article of food ; but says, that
it is apt to disagree with the stomach, and to prove flatulent. The learned
Varro says of milk : '* Est omnium rerum quas cibi caus& capimus liquen-
tium maxim^ alibile, et id ovillum, inde caprinum." De R. R. ii. 11.
Aristotle arranges the milk of the Camel, the Mare, and the Ass, in the
same order with respect to consistence as Galen. H. A. iv. 20. Pliny, evi-
dently having in view this passage of Aristotle, says, that the milk of Camels
is the thinnest, then that of the Mare, and that the milk of A^es is the
thickest. This is going further than he was justified by his authority. He
remarks, that the milk of Cows gives the most cheese. H, N. xi. 41.
Dioscorides calls milk nutritious, laxative, and flatulent. His account of
its properties is interesting. Lib. ii. 74.
All the Greek authorities subsequent to Galen evidently copy from him.
Seth says, that the longer milk is kept the worse it becomes. When pro-
perly digested, he adds, it moistens the body, induces soundness thefeQf,and
is useful in complaints of the chest.
According toHaly Abbas, the milk of cows is the thickest of all, and the
most nutritious ; that of camels the thinnest, and the least nutritions ; goats*
milk is intermediate between them ; the milk of sheep, intermediate betweeii
that of cows and of goats ; and the milk of asses, between that of goats and of
camels. Thtor. v. 26. Rhases enumerates them in a considerably difiereat
order ; he says that the milk of cows is the thickest, and that of asses the
thinnest ; while that of goats is intermediate. Ad Mantor. iii. 15. Averrhoes
calls the milk of asses and of goats the best. See also Serapioo, ex AnimalU
husy c. 457 ; and Avicenna, lib. ii. tr. 2. c. 434.
The following remarks of Macrobius seem to me very acute and pertinent;
and, if well founded, they ought to operate as a powerful consideration to
COMVSNTAET ON THB FIRST BOOK. 115
erery healthy mother to suckle her own offspring. ** Quamohrem noo frus-
tra creditum est, sicut valeat ad finsendas corporis et aDimi sirailitadines vis
et natura semiDis, non secus ad eandem rem lactis quoqiie iDgenia et proprie-
tates valere. Neque in hominibus id solum, sed in pecudibus quoque animad-
versum. Nam si ovium lacte h«di, aut caprarum agni forsitan alantur : constat
ferme in his lanam duriorem, in illis pilum gigni tenehorem." Saturn, v. 11.
TheOalactophagi, a Scythian nation who lived principally ujpon mare*8 milk,
are made mention of by Homer, lUad, liii. and by Stobaeus, Semio v. Eusta-
thius says that they made much use of a preparation from milk, called Ory-
gala. Ap. Iliad. U.S.
Aristotle calls Butter the fat of milk, which has concreted to the consistence
of oil. Hist. Animal. Hecatflms, in Athenaeus' Work, calls it the oil of milk.
De^noi, lib. x Dioscoridet says that it is used for condiments instead of
oil, and in confectionary instead of suet.
LXXXVII.»-ON THB DRINKING OF MILK.
This Recount of the process of administering milk is taken from Oribasius,
who^ in his turn, is indebted to Rufiiis. Avicenna, in like manner, copies
from Ruffns. There is not in any other ancient author so full a description
of the process of boiling milk. On the ancient modes of preparing milk for
various purposes, and their uses, see Oeapon. lib. xviii. and Plinius, H. N.
nviii. 38. Pliny mentions that some cure gout in the hands and feet by
imlk. This seems a vciy plausible practice ; for Dr. Cullen observes that he
never knew a person Wbo lived upon milk and vegetables who was subject
to goot. Mat. Med. Simeon Seth joins our author, or rather Ruffus, in re-
commending boiled milk in Dysentery. He likewise praises its effects in
Phthisis and dry Coughs.
. Tbil method of preparing milk for use, by putting heated stones into it, is
mentioned by Dioscorides, Pliny, and others. Serapion recommends heated
iran. See the following chapter. Gkden was aware that milk coagulates in
the Stomach before it is d^^csted. De AL Fac. in. 15.
LXXXVin. ON THB BCHI8T0N, OR MILK 8BPARATBD INTO PARTS.
Tbb method of preparing the Schiston is thus described by Pliny : — " Me-
dici speciem unam addidere lactis generibus, quod schiston appellavere. Id
fit hoe iBodo : fictili novo fervet caprinum maxime, ramisque ficulneis recen-
tflHis miscetur, additis totidem cyaUiis mulsi, quot sint hemine lactis. Cum
iurveti ne drcumfundatur, prsstat cyathus argenteus cum frigid a aquademis-
ses ita ne quid infundat: ablatum deinde igni refrigeratione dividitur et dis-
oedit serum a lacte." H. N. xxviii. 33. The same process is briefly described
bv Dioscorides, lib. ii. 77. Pliny recommends the whey thus prepared for
Ailepsy, Melancholy, Paralysis, Leprosy, Elephantiasis, and Arthritis.
This prepars^on of milk is often noticed by the ancient authors on medicine.
It evideiitly consisted of the whey of the milk, separated from the cheese by
a fedo^iar process.
The Mdca was a preparation from Milk, and is mentioned by our author
IB another place, (lib. iv. c. 27.) It appears to have been a sort of curds
aod whey, or du lait cailU of the French, prepared by pouring hot vinegar
vpoB milk. The process is minutely describea in the Geoponics, lib. xviii.
The Ozygal, or Lac Acidum, consisted of the caseous part of the milk, se-
parated from the whey by a very complicated process, which is fully described
by Columella. Lib. xii. c. 8. It is said by Galen to posssess very refrigerant
piopertics.
i2
116 COMMBNTART ON TBM FIRST ROOK.
The Aphiogala, or Spuma LactU, appears to have been Milk reduced to
a state ot foam by violent agitation.
LXXXIX. — ON CHBBSB.
Hippocrates calls cheese flatulent and indigestible. Celsus also calls it
flatulent, and ranks old cheese among the unwholesome articles of food. He
speaks &vourably, however, of soft new-made cheese. Dioscorides, in like
manner, says that new-made cheese without salt is nutritious, good for the
stomach, of easy distribution, forms flesh, and is moderately laxative. Old
cheese, he adds, is constipating. Pliny describes the kinds in most repute
wheal he lived. H. N, xi. 97. He says that salted cheese wastes the body,
but that soft is nutritious. Lib. xxviii. 34. Varro, in like manner, says that
soft and recent cheese is nourishing, and not astringent, but that the old and
dry is the contrary. De R, R, ii. 11.
Galen's account of the nature and properties of Cheese is so ample that my
limits will not admit of my doing justice to it in my brief abstract He re-
marks that milk, when it is converted into cheese, loses its watery part, and
acquires heating properties, whence it becomes more apt to excite thirst, more
inoigestible, and unwholesome. He speaks most favourably of new-made
cheese, and mentions that there was a kind much used by rich Romans, called
Vatusicus, which was peculiarly excellent. As to consistence, the best
cheese, he remarks, should be intermediate between the glutinous and the
friable, and it ought to possess no distinct quality as to taste, unless pnerhaps
a certain degree of sweetness. Aetius, Oriluisius, and Simeon Seth, evidently
adopt the views of Galen. Seth says that new cheese is laxative, and old
astringent.
The Arabians deliver the same characters of Cheese as their Grecian mas-
ters. Avicenna, Averrhoes, and Haly Abbas, speak favourably of new cheese,
as being of a cold and humid nature.
Hippocrates and Pliny mention a species of Cheese prepared by the Scy-
thians; from mares' milk, and called by them Hippace.
XC. — ON FISHBS.
Ancient authors make mention of whole nations of mankind that subsisted
entirely upon Fish. For an account of the Ichthyophagi, see Herodotus,
lib. iii.c.20. — Plinius, lib.xi. — Strabo, Geogr. lib. xv. — Diodorus Siculus,lib.
c. 15. — Ptolemaeus Geogr, lib. iv. — Arrianus, inlndicis. — Solinus, Po/yAtstor,
lib, Ixv. — Philostratus, in Vita Apolloniiy lib. iii. The description given of
them by Diodorus is the most circumstantial and interesting. He says that
the simplicity of their diet preserved them free from diseases, but that they
were short-lived. Pliuy states that Fish were used by his countrjrmen as
food from the building of the city. H. A\ xxxii. 10. Eustathius says that, in
the Heroic ages, they were seldom used but in cases of want. Ap. Iliad. ▼. 487.
Hippocrates thus details the Dietetical qualities of fish. Speaking gene-
rally, then, he says Fishes are light food, both when boiled and roasted, by
themselves or witij other things. They differ from one another as follows : —
Those which live in lakes, the fat, and river fishes, are heavier; of sea fish,
such as are found near the shore are lighter, and those which are well boiled
are lighter than such as are roasted. The stronger kind, therefore, are to be
given when our object is to recruit, but the lighter when we wish to attenuate
or reduce. De Affect, cap. 46.
Celsus ranks Fish among those things which hold an intermediate place
between articles of a strong and of a weak nature. He thus distinguishes
COMMBNTART ON ^HB FIRST BOOK. 117
thefn from one another : — ^ Levior piscis inter saxaeditu8,quam in arenii, le-
vior in aren^ quam in limo : quo fit ut ex stagno, vel lacu, vel flumine eadem
genera graviora sint: leviorque, qui in alto, quam qui in vado vixit.''
Plutarch states that Fish is much more easily digested than Flesh. Sympos.
lib. iv.
For a fully interesting, and judicious account of the qualities of Fishes as
articles of food, see Athenseus, Deipnos, lib. viii. 14. I canouly afford room
to mention his opinion of their more general properties. He says, then, upon
the authority of the Siphnian Diphilus, that of sea fishes those that live
among rocks are of easy digestion, contain good juices, are detergent, light,
and alford little nourishment; and that those which inhabit the depths of the
sea are difficult to digest, very nutritious, and of difficult assimilation.
Galen states that Fishes which live in marshes, lakes, and muddy rivers^
are the worst as articles of food, because they are little exercised in swim-
ming, and have impure food. Such fish as live in the depths of the sea, he
saysy are almost firee from fault as aliment, for they are more wholesome and
delicious than any of the others. He mentions, as the characteristics of good
fish, that they have no offensive taste or smell, have little fat, and can be kept
for a considerable time without becoming putrid, especially if put in ice. He
says that Fish are the best possible food to persons of indolent habits, old
men, and invalids, but that they do not answer so well with persons who take
strong exercise.
Of Fishes, as aliments, there is an excellent account in a Fragment of
Xenocrates, lately published, with interesting Notes, by the learned Dr.
Coray of Paris. He says that roasted fish are most nutritious, but are of dif-
ficult evacuation ; that the boiled are less nutritious, but are readily evacuated;
that sea fish are savoury, agree with the stomach, are of easy distribution,
form proper blood, impart a good colour, and clear the belly. Such as live in
rivers and lakes, he adds, are bad for the stomach, form thick juices, and are
of difficult evacuation. The characters of the different Fishes are afterwards
stated by him very fully. He says that the parts next to the tail, as being
most exercised, are most wholesome.
Oribasius's account of Fishes is mostly taken from Xenocrates. Aetius is
full and correct on this subject. He says that the best fish are those which
live in a sea of pure water, especially if it be agitated by winds, and if its
shores be sandy and not clayey.
Actuarius says, that of Fishes which live at the sea-shore, and among rocks,
the larger supply much nourishment, of a thick nature ; and the smaller, lit-
tle nourishment, of a pure nature. He says, further, that sea fish in genera),
being preferable to those which live in fresh waters, differ however from one
another in several respects ; that such as live in the open sea are more exer-
cised, and enjoy purer food, than the others, and hence their fiesh is firmer
and purer, and they are more nutritious, and form thick blood ; that such as
live in canals and marshes are bad and unwholesome ; and that those which
live among rocks in pure waters have better flesh, and, being light and di-
gestible, form thin and pure blood.
Simeon copies freely from Galen and our author. Upon the whole, he
says, the blood which Fish form is thinner than that from land animals.
Fish, he says, is the most proper food of invalids and convalescents.
Rhases states that Sea and River fishes are the best, especially such as
have rough scales, are not mucilaginous, and are naturally of a white colour.
Those, he adds, which are of a black or red colour should be abstained from.
He saya that all fish remain long in the stomach undigested. It is now ge-
nerally admitted that they are less digestible than the tender flesh of quad-
rupeds.
Avicenna delivers the general characters of Fishes in the same terms as
Galen. He says that the best are those the flesh of which is neither too hard
116 COMlfSMTART ON THS FIRST BOOK.
and dry, nor, od the other hand, too macilaginous^-^nd which are nei-
ther very large nor very small. Averrhoes repeats this accoant of then.
Ilaly Abbas, in like manner, abridges Galen. He says that fresh fish are of
a cold and humid nature, and engender phlegm.
The ancients ate their Fish either roasted, boiled, fried, or in soups. In-
valids were recommended to take them boiled. The fried were believed to
suit only with persons of a strong constitution. On the Soups, see Z«»/mk in
lib. vii.
We shall now offer a few remarks upon some of the Fishes which were in
most request at the tables of the ancients.
The Laibrax, or Lupus, is generally supposed to have been the Pike. But
Aristotle, Oppian, and Ousiodorus describe it as being a cunning iisb, which
does not accord with the character of the Pike. Bochart concludes, that it
is the fish called XuvpaiUy by the modem Greeks ; Varoloy by the Italians ;
and Bar, by the French. It was probably, then, the Barb. locsins, as
quoted by Athensus, says of it, that it contains good juices, but is not very
nutritious, nor readily evacuated, but is the most delicious of all fishes. Ar-
chestratus calls it *^ the ofispring of the gods." Lupi caught in the Tyber
were esteemed the best. See Horace, iS^^. lib. ii. s. 2, and Macrobios, Sa-
turn, iii. 16. There were two species, the Lanatus and the Varins, of which
the former was in most esteem. Ausonius says, tliat it is the only fish which
age improves.
The Rhombus was esteemed a remarkable delicacy. The classical reader
will recollect the ludicrous importance attached to the capture of one by the
flatterers of Domitian, as described in the 4th Satire of Juvenal. It is fi«-
quently made honourable mention of by Horace and Martial. According to
liarduin and Nonnius it was the Turbot. Athensus calls it sweet and nu-
tritious. Celsus ranks it among ^^ res boni succi.'' According to Atheneus,
it is the same as the ^Inftra of Aristotle. It is called '^uno¥ by Seth. V.
Not a Bogdani.
The Cephalus w:is a species of the Mullet, as is stated by Harduin, ap.
Plinii, H. N. ix. 26, Schneider, ap. ^liani. Nat. Anim, i. 12, and Lu-
dovicus Nonnius. Oppian describes the fishing of it in the most striking
manner. Galen remarks, that the flesh of it differs much in quality accofd-
ing to the nature of the place in which it is found. Athenvus ranks it among
the fishes which are sweet and nutritious. Simeon Seth and Aetius say, that
the River Mullet is bad for the stomach, indigestible, and apt to form
phlegm. It appears from Anaxilas, as quoted by Athensus, that its head
was in most repute. Archestratus says that it is best in the winter season.
The Trigla, or Mullus, as Nonnius, Harduin, Schneider, and Coray state,
was the Surmullet. It is mentioned as a rare delicacy of grant price by
Horace, Sat. ii. 2, Juvenal, Sat. iv. 15, Martial, Xenia. c. 74, and Macro-
bius, S/ttumal. iii. 16. Athensus says of it, ^ Diodes writes that the flesh
of the Mullus is hard.'' Lib. vii. 21. Its liver prepared with oil and wine is
said by Galen to have been esteemed as a peculiar delicacy.
I need not say how much the Murene was sought after by all the lovers
of good eating in ancient Rome. Pliny, Martial, and Macrobius inform us,
Uiat those from Sicily were in most esteem ; and Brydone takes notice of
the peculiar excellence of the Sicilian Murenes at the present time, or, I
should rather say, when he performed his tour through that Island. According
to Icesius, it is as nutritious as the Eel. Athen. Deip, lib. vii. Apicius gives
various receipts for the dressing of it. Pepper, wine, vinegar, and oil are ingre-
dients in almost every one of them. The Murene which was served up at
the supper of Nasiedenus had a sauce or soup formed of such things. Hora-
tius, Sat. ii. 8. It is related of Vedius Pollio, that he fed his Murenes with the
bodies of condemned slaves. Plinius, H, N, ix. 23, and TertuUian, dc
COMMBNTAKT ON THB flMT BOOK* 119
FaUio, L. CiaMuiy the oralDr, put on mouniiog clothes for the death of a
Mureoe. Macrobiosy Sat, iii. 15.
It is supposed, by most of the classical commentators, that the Acipenser
was the Sturgeon, but this is not certain. Its popularity appears to have
been great in the days of Horace, but it had fallen mto disrepute in the time
of Pliny. It seems, however, to have retrieved its character afterwards; for
one of the authorities quoted by Atheneeus, says that it was presented at the
Roman banquets, crowned with garlands, and accompanied with the playing
of pipes. See also Macrobius, Sat, iii. 16. Martial speaks of it as a much-
esteemed delicacy at the Imperial table. The Elops and the Galeus Rho-
dhis were fishes nearly allied to the Acipenser. See Pliny and Athensus.
Martial mentions the Gobius, or Gudgeon, as being the first of the Viands
presented at the banquets of the Venetians. Xenia, £p. 83. Juvenal speaks
of it as being a fish of little value, or, at least, low priced. Sat, xi. 37. It
is in feet, as Galen states, a very small fish ; but he represents it as being de-
licious, digestible, and wholesome, especially when caught on a stony or
rocky shore. Seth gives the same account of it. Diphilus, as quoted by
Athensus, says, that when its flesh is white the Gudgeon is tender, whole-
some, and digestible. The Perch, according to the same authority, bears
a close resemblance to the Gudgeon. Ausonius calls it the delicia mentO'
rum, Galen calls it a delicious fish, which is not only of easy digestion
but most wholesome. He adds, that it, and other fishes of the same descrip-
tion^ fbna blood of a middling consistence, that is to say, neither very
watery nor too thick. And here, by the way, I would notice the opinion of
Dr. Cullen, who denies that fish afibrd weaker nourishment than fiesh does.
Dr. Paris, however, agrees with the ancients, that fish do not afibrd the same
strength and stimulus to the body as the flesh of certain land animals.
The Aaguilla, or common £el, and the Congrus, or Conger-£ef, were de-
spised by the Roman gounnands, but were greatly esteemed by the Greeks.
Icesios says that £els are the best of fishes.
On the Salmon the Greek authors are entirely silent. It is briefly noticed by
Plioyy H, N, ix. 32 ; but the first and only satisfactory account of it which is
to be found in any Latin classic, is contained in the Mosella of Ausonius. As
the Salmon is the most esteemed of all fishes in the part of the country where I
leside (^ Abredonia Salmonum piscatu nobilis,'' Buchanani Hist, Scotia:\
I am induced to give an extract from the lines in which it is first correctly
described:
'* Teqne inter species gemhias, neatromque et ntrumqoe,
Qui neodom Salmo, nee jam Salar, amUgmuqae
Amborom medio Fario interoepte sub sevo.'*
Here we find marked distinctly the three progressive stages in the growth
of the fish. The Salar is evidently the Sea Trout, the Fario is what in the
with of Scotland is called the G(ifse, and the Salmo is the full-grown Sal-
mon. Of the Salmo he says :
'' Ta lorieato sqnamosus pectore, frontem
Lnbiicusy et dubue factums fercula cense,
Tempera longamm fers incorrupte morarum,
Pnesignis macnUs capitis : cui prodiga nutat
AlvQS, opimatoque fluens abdomine venter."
The Sea Trout is well described in the following line :
** Porporeisqae Salar stellatus tergora gattis.''
Ladovicus Nonnius conectly remarks that, although the head of a Salmon,
^ being the fattest part, be in most esteem with gourmands^ it is not the most
120 COMMBNTABT ON THX FIMT BCM)K«
wholesome. The whole fish, he says, is of difficult digestioD, and forms
thick chyle. He considers it to be the Aruhordgo oi Oasiodonu. De Etu
Piscium^ c. 31.
Ludovicus Nonnius confesses his inability to determine what the Scani»
was. Xenocrates praises it as being savoury and of easy digestion, but of
difficult distribution and evacuation. For a curious account of it, see Ma-
crobius, Sat. iii. 16.
The Aurata, called by Nonnius in French Brame de mer, and by AinswortH
and Artedi Gilt-head in English, is said by Celsus, and Mnesitheus as quot-
ed by Athenseus, to be a fish of difficult digestion but very nutritious. Xeno->
crates says, that its flesh is firm, white, of easy distribution, and nutritioas.
The Passer, called Platessa by Ausonius, is supposed by Artedi and Non-
nius to have been the Plaise. It is mentioned by Horace among the deH-
cacies at the sujpper of Nasiedenus. The Solea or Sole, called Lingualaca
by Festus and Varro, was nearly allied to it. Diphilus says, that both are
very savoury and nuti*itious.
The Lampetra, or Lamprey, according to Nonnius, is the Mustellaof Auso-
nius, the Exormiston of Cassiodorus, the ydka^ias of Galen, the *x^prfi9 of
Oppian, and the ^Xka of Strabo. It was reckoned unwholesome.
The Capros, or Carp, is called by Archestratus " The Flower of Nectar/"
Athen. Deipnos. lib. vii.
XCL — ON THE TESTACBA AND CBU8TACBA,
Dr. CoRAY correctly states in his Note* on the Fragment of Xenocrates^
that, in the ancient classification of Animals, the oarpeucfaSff or oarpaKobtpfiOy,
were subdivided into the o-ickrjpxHrTpaKci^ or Testacea, comprehending
Oysters, Muscles, &e. ; and the fiakoKoarpaiea, or Crustacea, compr^ending
the Crabs, Paguri, &c. But, as he remarks afterwards, the fniaipwrrpoKa
were often called by the generic term, o<rrp€ueob*pfia. The following are his
words : *^ 0<r¥paKta icaXct a Koivortpov oarpcucolitppa'KeYtTat* Taora dc dccii'*.
pfLTM €is r€ ra o-KkrfpoirrpaKa ra km r^ ytvuctj^ r&v oarpoKo^ppMV otfopan
&g cifi TO iroXv K/dkovpfvcL, Kai ra paKoKoarpcuca otoi €uriv aoTOKOiy Kapafitu^
Kopidcff, irayovpoiJ* The ancient division of the lower classes of animals is
derived from Aristotle's History of Animals, lib. iv. and with some sttgfat
modifications it is the same as the classification lately adopted by Baron
Cuvier. Pliny thus distinguishes the Mollusca, Crustacea, and Testacea :
** Piscium quidam sanguine carent, de quibus dicemus. Sunt autem tria
genera: in primis quee mollia appellantur (^3io//ttsca?J: deinde contecta
crustis tenuibus (Crustacea f) : postremo testis conclusa duris ( Testacea 1).
Mollia sunt, loligo, sepia, polypus, et cetera ejus generis,'^ &c. In another
place, however, he introduces confusion by applying the term Mollia to the
Crustacea. This mistake probably originajted in the resemblance between
the Greek terms /xoXoxta and pciKcucoa-rpaKa. H. N, lib. ix.
I may mention further, that, in Oppian's delightful Poem on Fishing, the
Crustacea are described at book i. 1. 259, the Testacea at 1. 283, and the
Mullusca at 1. 638. On the terms used by ^lian, see de Nat. Animal, ix. 6.
Ed. Schneider. Athenaus gives a long disquisition on these animals in the
third book of the Deipnosophista.
We shall now briefly notice the ancient opinions on their Dietetical qua^
lities. From Atheneus, I can only find room for the following extract:
^* Regarding the Testacea (o(rrf>ajcod€pfia) the Siphnian Diphilus writes thus:
* Of the Testacea, the Squilla, Astacus, Locusta Aquatica, Cancer, and Leo
Marinus, are of the same genus, but differ from one another : the Leo is
larger than the Astacus, the Locusta is more fjeshy than the Cancer, and the
COMMSMTAET ON tMM fIBftT BOOK. 121
Cancer, or Crab, is heavy and indigestible.' Mnesitbeus, the Athenian, in his
work on Dietetics, says, that the I^custa, Cancer, Squilla, and the like, are
all of difficult digestion, and yet they are much easier digested than other
fishes."
GraleQ*s accoont of them is interesting; but our author's is abridged from
it. In general, he remarks, those which have hard flesh are most nutritious,
but indigestible. They all contain saltish juices whidi are of a laxative na-
ture. He says of the Crustacea that they have all firm flesh, and are, there-
fore, difficult to digest, but nutritions. Aetius and Oribasius copy from him
without the slightest alteration of any consequence.
According to Dioscorides and Alexander, the Echinus is stomachic and
diuietic. j£lian, in like manner, calls it a restorative to a weak stomach.
H. N, lib. xiii.
Actuarius sajTS, that the Crustacea hold an intermediate place between the
FUhes and MoUasca; that they are, therefore, not so indigestible as the
Mollusca, and form purer and thinner blood ; that the Testacea, as they get
no exercise, are less proper; and that all form a thin and vratery blood.
I need scarcely remark, that the Romans esteemed the Cochlea, t. e, li-
macon, or White Snail, as an exquisite delicacy.
Simeon Seth's accouqt is entirely borrowed nom Galen.
The receipts of Apicius for dressing the Ixxiusta and Carabus contain
pepper, cumin, rue, mint, vinegar, wine, and oil.
It appears from Uie following lines of Juvenal, that British Oysters were
greatly esteemed by the Roman gourmands : —
** C^Tcma nata forent, an
Lucrinum ad saxnm, Rutapinove edita fdndo
Ostrea caUebat, prime dqprendere morsn.'* — Sai, iv.
Rochester is supposed to be the ancient Rutapinum. Seneca represents
tbem as wfaetters and not food. ** Ostrea non cibi, sed oblectamenta sunt,
ad edendum saturos cogentia." The Poet Matron, as quoted by Athenaeus,
calls them ** the Truffles of the sea." Athenseus says, that Oysters caught in
the sea adjacent to a lake or river are the best. Xenocrates remarks, that sea
Oysters are small and saltish.
XCII. — ON THK MOLLUBCA, OR MOLLIA.
Galen remarks, that the Mollusca, or Mollia, have no scales, nor any
rough Testaceous sdcin, but a soft one like that of men. Their flesh, he says,
is hard, indigestible, and contains a small proportion of saltish juices; but,
if digested, it aflbrds no little nourishment to the body. The Sepia, or Cut-
tle-fish, was anciently, and is at present, much used in Rome as an article of
food. Pliny states, that it is laxative. He adds, that it is taken in food,
boiled with oil, salt, and barley-meal. Simeon Seth says of it, that it is dif-
ficalt to digest, but that, if digested, it aflbrds considerable nourishment to
the body, and engenders crude humours ; on which account, it ought to be
taken with acrid condiments, and an old thin wine drunk afterwards.
Maesitheus, as quoted by Athensus, says, that the flesh of the Mollusca is
indigestible and aphrodisiacal.
Apicius directs to dress them in much the same way as recommended by
Seth, that is to say, he recommends to add to them spices, hot aromatics,
^iae, vinegar, and the like.
122 COMMJKNTAAT OV THX FIBST BOOK.
XCIII.^^ON THB CABTILAOIMOUS FIgHBB.
For an account of the ctKaxt, or Cartilaginea, see Aristoteles^ H. A.
lib. V. — Plinius, H, N, ix. 40- — Oppianus, Haiieut, lib. i. — ^^lianns, N. A.
xi. 37.
Galen says, that tiiey are called irtkax'i ^m o-cXar fX'w, because their flesh
has a shining appearance at night. He states, that they are moderately nu-
tritious. He remarks, that the parts abont the tails of such fishes are more
fleshy than the middle.
According to Athenaeuny the Cartilaginous Fishes in general are flatulent,
fleshy, of difficult digestion, and, if eaten in great quantity, blunt the sight. —
Deipnos. lib. viii.
Dr. Coray says, that the Frendi call the Punj Ange or Angelot, the Baros
Raie bouclee or Cavellade, the Atioparog Raie miralet, the f^apicrj Torpille
or Raie torpille, and the Tpuy^v Pastinaque. Harduin gives them nearly
the same French names.
XCIV.*— ON THB CBTACBA.
Galen states, that the flesh of all the Cetacea in its recent state is excre*
mentitious, but when pickled becomes more attenuate and easier converted
into blood. He gives them, in short, the same characters as our author does.
For a full account of the pickled fishes of the ancients, I refer to the Frag-
ment of Xenocrates, and the third book of Atheneeus. I shall give the general
character of them as delivered by the latter, upon the authority of the Sipb-
nian Diphilus. He says, that the pickles prepared from sea, lake, and river
fishes, aSOford little nourishment, contain few juices, are of a heating rmtaare^
are good for the belly, and whet the appetite. The old, he adds, are better
and more acrid. See also Galenus, de Alim, Facult, iii. 41.—- Hippocrates
saysy that they are desiccant, attenuant, and for the most part laxative. De
DuBta, — Diphilus says, that they are whetters and laxatives; and henee
Galen directs to take them at the commencement of a meal, and partioilarly
recommends them for old men. Rhases speaks more un&vourably of them.
It may be proper in this place to give some account of the Ist^to, or IskiOy
of the ancients. With regard to the etymology of th^ word, then, it is de*
rived by Macrobius, ab insectione. They consisted of minced meat, either
flesh or fish, boiled or roasted, and seasoned with pepper, cnmin, lovage, and
the like. Apicius gives receipts for preparing several dishes of this kind,
from the Loligo, Sepia, Locusta, and Swines Liver. The last-mentioiied
was inclosed in the omentum, or cowl, and must therefore have resembled
the dish now called a Haggis. Lampridius says, that the Emperor Hdio«
gabalus was the first who prepared Isicia from fishes. Oysters, Lobsten,
Squills, and the like. If this statement be true, the works of Apidus, which
we possess, cannot be genuine. On the Isicia^ see further Ladovicus Non-
nius, de Piscium Em, c. xxxviii. and Lambecius, op, Apk,
XCV.— ON THB FROPBRTIBS Of WINB,
The opinions of the ancients on this interesting subject may be best learned
by consulting Hippocrates, de Diatd, lib. ii. 22, et alibi — Census, lib. ii.—
Plinius, H, ff, lib. xiv. and xxxiii. 22-26 — Dioscorides, lib. v.---Giden!»,
de Sanit, Tuend, lib. v. 5. and de^Alim, Facult, lib. iii.— Oribasius, Med, Col.
lib. V. and Euporist. u 12. — ^Aetius, lib. i. — ^Athenaeus, Deipnos, lib. i. —
OOMMBlfTAET OM TBB rUMT BOOK* 128
Macrobiufl) Saiurnal, — ^Actuarius, de DktUy c. 8 — Simeon Seth^ de AUmen-
/is— Senpioiiy ib SimpHciinu^ ifc, — Haly AblNts, Tkeor, v. 30^ and Pract.
i. 8 — ^ATioenna, lib. i. fen. 3. doct. 2 — Rhases, ad Mamor, iii. 5, and Con-
tinent, lib. xxxvii. — AlsabaraTius, Theor, xiii. 2w— Stolraens gives an interest-
ing collection of the opinions of the Philosophers and Poets, Sermo xviii.
For an ample account of the ancient and modem wines, the reader is
particularly referred to the late ingenious and classicai publication of Dr.
Henderson. See also Barry on Andeni FFtnes, and Canonherius, de Admi-
randis Vini Virtutibui.
From the works of Moses and Homer, we learn, that the art of coDverting
the innocent juice of the Gfape into wine must have been a very early in-
vention. Eostathius informs us, that, in very ancient times, the wines were
all of a dark-colour ; and hence Homer applies to the Sea the epithet of
wime^oiouredijiufom worrov). Comment, in Iliad* I, However, in the time
of Hippocrates, they had wines of all colours, as well as characters. He
ihus oMcribeB their general properties. Black and austere wines are of a
drying nature, and are not laxative, nor diuretic, nor sialogogue. It is their
hax that renders them desiccative, by consuming the humidity of the body.
The soft dark vrines are of a more diluent nature, and are more flatulent and
laxative. The sweet dark wines are of a men mmstening nature, but they
are heating and flatulent by imparting humidity. The white austere wines
are heatiiig, but are rather diuretic than laxative. The new are more laxa-
tive than the old, as being a nearer approach to Uie fresh juice of the grape,
and they are nutiitious ; and the fragrant wines than those of the same age
whicb luive no bouquet, because they are better concocted ; and the thick than
the tkin. Bot thin sweet wines are more diuretic, laxative, and diluent, and
form weak blood.
Celsiis ranks the ^ vinnm dulce vel lene'' among the ^ res boni succi.'^
Sharp awMtere wine he places among the things which are most suitable for
the stomach.
Dioecorides deUvera very judiciously the different characters of wines.
He concludes with leniarking, that, although habitual intoxication be preju-
dicial to the bcahb, a moderate indulgence in wine for some days, especially
ifter drinking water, is beneficial, by proving an alterative to the sjrstem,
pargiiig the secretions, and promoting the insensible perspiration.
From Pliny's excellent detail of the Medicinal and Dietetical properties of
Wine, I select the following remarks : — ^* Vino aluntur vires, sanguis color-
^ae hominum. Vino modico nervi juvantur, copiosiore laeduntur, sic et
4)cttli. SComadius recreatur; appetentia ciborum invitatur; tristitia et cura
liebetatur; urina et algor expellitur; somnus conciliatur. Preterea vomi-
tees siatit. Vetus coposiore aqua miscetur, magisque urinam expellit;
Hiims siti resistiL Dulce minus inebriat sed stomacho innatat; austerum
4etli«is concoquitur. Stomacho minus utile est pingue, nigrum, sed corpoca
nagis alit. Tenue et austerum minus alit, magis stomachum nutrit."
The information supplied by Galen on this subject is most ample, but in
(oo diffuse a -shape to suit my narrow limits. Upon the whole, he states,
tbin wines are diuretic, but supply little nounshnient, whereas the thick
lie proportionally nutritious. He says, that the Falemian, especially the
sweeter kind, is one of the most wholesome wines. Athensus gives an in-
teresting account of the Falemian, upon the authority of Galen. He says,
it is fit to be drank af^er it is ten years old, and from fifteen to twenty ; but
that, when older, it occasions headach and affects the nerves. He describes
two kinds of it, the sweet and the austere. The latter, he adds, is off a
yellowish colour, that is to say, a colour intermediate between the white and
l>lack. Dr. Henderson concludes, that the modem Madeira is a near ad-
pioach to the ancient Falemian. Galen gives very minute directions for
124 COMMENT ART ON THE FIRST BOOK.
forcing this wine, or giving it premature age by heat. De Antid. lib. i.
Athensus says, that wine digests the food, and, being of a subtle nature, pro-
motes the distribution of it. Although wine does not promote the digestion
of food chemically, it may rouse the vital energies of the stomach to perform
its functional office.
According to Actuarius, the thick wines are most nourishing and form the
thickest blood, but are apt to occasion visceral obstructfons; while, on the
other hand, the thin wines are more stomachic and less nourishing. The
sweet are the contrary ; but the white are less hot than the others ; the gold-
coloured are more hot; and then the red.
Wine, says Simeon Seth, is not only nutritious, but promotes in a great
degree the distribution of the food over the body, rousmg, and at the same
time increasing the vital heat, and with it the urinary and other secretions.
It suits best, he says, with persons of a cold and dry temperament ; and,
therefore, it is most proper for old men. He adds, that the immoderate use
of wine dissolves the vital tone, depresses the natural heat, and occasions
apoplexy, epilepsy, and tumors of the body. Macrobius attempts to trace a
resemblance between the effects of habitual intoxication and those resulting
from exposure to extreme cold. ** Quscunque nimium algentibus, eadem
contingunt ebriis. Fiunt enim tremuli, pallidi, graves ; et saltu tumultu-
antis spiritus artus suos et membra quatiuntur. Idem corporis torpor am-
bobus, eadem linguse titubatio. Multis etiam morbus ille quem vapaKva-of
Grsci vocant sic nimio vino, ut multo algore contingit.'' Id like manner, ft
modem writer, Andreas Baccius, maintains that some wines are of a cold
nature.
Haly Abbas gives nearly the same characters of wine as Seth. His ac-
count of all the wines, natural and artificial, used in his time, is most ample.
Alsaharavius forbids to take wine when the stomach is quite empty, or
after a full meal. When taken seasonably, he says, it improves the appetite,
increases the vital heat, nourishes the body, and clears the senses.
Avicenna, with his usual judgment and industry, collects all the infinma-
tion of preceding authors, to which he adds his own opinions. He remarks,
that the immoderate use of wine induces disease of the liver and brain, ana
debilitates the nerves.
Wine, says Rhases, warms the stomach and liver, and dispels flatulence,
promotes digestion, provokes the urinary and alvine discharges, and glad-
dens the mind.
Serapion copies mostly from Galen in delivering the general characters of
wine. He disapproves of wine made with salt water. For an account of
it, see Pliny and Athenseus, u. s.
The ancients were scarcely more agreed respecting the intoxicating pro-
perties of Wine than they were as to the powers of the Cabbage in counter-
acting them. Old Cato the Censor, who was in the practice '' of warming
his virtue with wine,'' describes the following method of cooling it : — ^ Si
voles in convivio multum bibere csnareque, ante ceenam esto crudam brassi-
cam quantum voles ex aceto, et item ubi csmaveris comesto aliqua V folia,
reddent te quasi nihil ederis, biberisque, bibesque quantum voles.'' De
R. R, c. 156.— See a long dissertation on this property of the Cabbi^e in
Athensus, Deipnos, lib. i. ap, finem ; also Plinius, if. 'N, xx. 34. — Pseudo
Dioscorides, Euporist, i. 24. — Nonnus, c. 14. — Simeon Seth, in voce BragsicUy
Geopon, xii. 17. Avicenna, Rhases, and Serapion, give the same character
of it. Traces of this opinion may be found in the works of Amaldus Villa-
novanus, Canonherius, Baptista Porta, Culpepper, and other modem
writers. I have been told, that the more intelligent votaries of Bacd^us at
the present day sometimes have recourse to this simple method of pacifying
COMMBNTART ON TBS FIRST BOOK. 125
his DiTinity I — Plutarch afiBrms, that Almonds also are a presenrative from
intoxication. Quast. wi.
Before quitting this subject, I must notice certain peculiar modes of pre-
paring Wine. The Mustum was Wine newly made, or the fresh juice of the
grape. The Protropum was the juice which runs from grapes without
pressing. The Mulntm was a preparation of Wine and Honey. Dioico-
rides recommends two parts of Wine to one of Honey ; but there does not
appear to haye been any fixed proportion. The Sapa, called by the Greeks
Mq^sema and Siraum^ according to Pliny is Must, boiled to a third ; and the
DefnUum the same reduced to a half. They are now called Robs. Tha
Carenum, according to Isidorus, is Must reduced to two-thirds. The Possum
was a sweet Wine prepared from grapes which had been much dried in the
son. The Possum Creticum, which is much praised by Pliny and Atheneus,
and is often mentioned by our author, the learned Andreas Baccius and
Nonnius beliere to have much resembled the modem Malmsey. The
ancients prepared a peculiar species of Wine with salt water. — See Plinius,
jff. N. Ub. xlv.
It is scarcely necessary for me to remark, that the ancients generally drank
their Wines duuted either with hot or cold water. Hence the poet Juvenal
says : — ** Quando ^ocatus adest calida gelidaeque minister.*' According to
Puny, Staphylus first introduced this practice, K. N, viii. 56; but Atheneus
refers it to Melampus, lib. ii. It would appear, however, from some pas-
sages in the Ecctesiazusa of Aristophanes, and from Eustathius's Com-
mentary on Homer, Iliad, ix. 203, that the ancients often drank their wines
undiluted.
XCVI. ON HONBT, AND MEAD, OR HONIBD WATBR.
HoKET, says Hippocrates, when eaten with other food, is nutritious, and
improves the colour ; but, when taken alone, it rather attenuates than recruits.
Actuarius says, that scummed honey, when taken with other food, is nutri-
tious and laxative. Democritus said, that health viras best promoted by lu-
bricating the inside with honey, and the outside with oil. Honey and bread
formed the fa?ourite food of the Pythagoreans. Athensus, Deipnos, ii. 7. —
See also Oribasius, Stfnops, iv. 38 — Haly Abbas, v. 27---Simeon Seth, in
voce Mel.
Galen gives the following account of the phenomenon of a Honey^shower : —
" I have sometimes known in the season of Summer a great quantity of
honey to be found upon the leaves of trees, shrubs, and certain herbs, so that
the country people said, jesting, * Jupiter has rained Honey.' A cold night,
as for Summer, had preceded (for it happened in Summer) ; but the tem-
perature of the former day had been hot and dry. It was thought, there-
lore, by those who were skilled in Nature, that an exhalation from the earth
a&d waters, finely attenuated and concocted by the heat of the sun, had been
condensed and collected by the cold of the succeeding night. This phe-
nomenon occurs rarely with us ; but it takes place frequently in Mount
Lebanon every Summer.'' De Alim. Faadt. — See also Fragmentum Theo-
phrasti de Melle ed. Heinsius. Emestus Faber states, that die Honey here
described is the Manna of Cedars. De Manna Ebraorum, c. 12.
Our author has given one method of preparing the Hydromel, or Honied
Water. Different modes are described by other authors. Thus, Mesne re-
commends to use seven parts of water to one of honey. It appears from
Hippocrates, however, that it was taken more or less diluted. Pliny and
Bioscorides make mention of Hydromel prepared by mixing two parts of
water with one of honey. This seems to have been the strongest Hydro-
126 COMMENTAET ON THE FIEST BOOK.
mel. A species of Hydromel carefully prepared, and kept ibr a considerable
time, was esteemed a delicious beverage. Ludovicus Nonnius compares it
to the Mead used by certain nations of the North. They prepare it with
hops and yeast, so tliat it it made to emulate the nature of wine.
XOVIL— ON SLEEP.
The philosophy of sleep is ingeniously treated of by Hippocrates, de In-
iornniUy and by Aristotle in his treatise de Somno et Vtgilia, Aristotle
states, that digestion goes on best during sleep. Plinjr's definition of sleep
seems to be taken from Hippocrates : — ** Est autem Somnus nihil aliod quam
animi in medium sese recessus.'* H.N. x. 97. Alexander Aphrodissus^ in
like manner, says : — '* Know, that during the day, the natural principle is
less occupied with its own peculiar operations, I mean the digestion of the
food, the changes of the chyle, sanguification, distribution, assimilation, and
the like, the mind being engaged in its other energies, namely, the five
senses, phantasy, reasoning, and memory ; but, during nisht, on the other
lumd. Nature operates more, and the mind less.'' — FrohUm 'u 1 18. — See
also particularly Oribasius, Med. Collect, ▼i.4. — Actuarius, de Diata c. 11.-^
Aficenna, lib. i. fen. 3. doct. 3/— Rhases, ad Mansor. iv. 3.^— Haly Abbas,
Tkeor. T. 35. — Alsaharavius, Theor. xi. 3. — Averrhoes, CoUect. §- i. 21.—
Aferrhoes defines sleep to be the recession of the sensorial powers from their
organs to the internal parts; and hence, he remarks, those who sleep with
their eyes open do not perceive the objects nearest to them. The vital heat
being then collected internally, he adds, the powers of the digestive faculty
are increased. Rhases agrees with Galen, that moderate sleep forms good
blood ; but that too much corrupts the juices, that is to say, impairs diges-
tion. Haly Abbas remarks, that, during sleep, the animal powers are sus-
pended, while the vital and natural continue unaflfected ; and, therefore^ ihe
mind or principle of life being then disengaged, as it were, from one of its
offices, is the abler to perform the others aright. Hence, he adds, digastion
ia best performed during sleep. Alsaharavius approves of taking rest after
a meal, but recommends to allow an hour to elapse before going to sleep.
Although foreign from my purpose to indulge in frequent quotations from
authors not strictly medical, it may not be thought much out of place hoe
to set down the following encomiums on sleep by three of the greatest poets
of antiquity:—-
** 'Ym^ olfvpat iiarfS, *Ynvi ^ Sky^mfy
EvaM»v, hfoiuitv Svet^f
Of/LiuMtrt l!^carrl(rxois rM d^Xvr, a rerartu rav^." — Sophocles, Philoc,
** Q (f>iKov viTPov BfKyrjrpop, eirucovpov votroVy
'Qg ^du fioi irpoarjkoes iv htovri ye.
Q frorvla \rj0rf rav kok&v, ms ci (ro^y
Km ToifTi bvarruxoKriv ivicrala ^eor.**— -Euripides, Orestes.
** Somne quies remm, placidissime Somne Deorum,
Fax animi, quern cura rogit ; qui corda ditumis
Fessa ministeriis mtdces, repaivsqae labori." — Onn. Metam, xi.
The reader will find in StentzeVs little treatise, entitled AurrpiPrf wept rov
trrvovy an interesting exposition of the opinions of the ancient philosophers
and physicians on this subject.
COMMENTARY ON THE FIRST BOOK. 127
XCVIII.— ON WATCHrULNB88.
We have mentioned in the 74th chapter, that Galen cured himself of watch-
fulness by eating freely of Lettuces. See further Oribasius, Med. Colled,
lib. vi. — ^Averrhoes, Collectan, ii. 5. — Alsaharavius, Theor, xi. 3. — Rhases,
Continens. lib. xxxi.
Rhases recommends lettuces, the tepid bath, the effusion of tepid water
on the heady and diluted wine. He also recommends mandragora and opium,
which, he says, Galen states will produce soporific effects, not only when
taken internally, but when rubbed on the forehead, and applied to the nos-
trib. He particularly approves of the following Liniment : Pound the bark
of mandragora, the seed of black henbane, and opium, with the juice of let-
tuce, and rub into the temples.
XCIX. ON CATAPHORA, OR 80MN0LBNCT.
See the Commentary on the Chapters on Lethargy and Cams in
Book. III.
C. THE EPISTLE 07 DI0CLE8 TO KING ANTIG0NU8.
This Diocles was an ancient physician of great eminence. Galen often
mentions him along with his idol, Hippocrates, as the greatest of medical
authorities. Cselius Aurelianus frequently quotes his opinions in respectful
tenns, although belonging to a different sect from his own. Pliny says, that
he was next to Hippocrates in fame as in time. Octavius Horatianus calls
bim the Younger Hippocrates. Athensus mentions a work of his on Poisons,
and another on Cookery.
Le Clerc questions the authenticity of this Epistle, but seems to have had
DO other grounds for his scepticism Uian the general suspicion which attaches
to all the Epistols Gnecanics. It is published in the Biblioth^ca Graca
of Albertus Fabricius, who appears to have been satisfied of its genuineness.
Mr. Moir, the author of Outlines of the Ancient History of M^icine, con-
demns it as Apocryphal, upon the authority of Schulze, p. 76.
HEADS OF THE SECOND BOOK.
In this Book, which is the Second of the whole Work, the subject
of Fevers is treated of. — First, Of those things which relate to the
Bymptoms and general core of Fevers ; neat, Concerning the origin
and treatment of each particular Fever ; and, third. Concerning the
complaints which usually follow Fevers.
1. Preface to the Book on Fevers.
2. Of the principal considerations to be inquired into with regard to
Fevers.
3. From Galen, what to call the commencement of the Disease.
4. How to know whether the Disease will be fatal or not.
^' How to know whether the Disease will be of short or of long duration.
6. How to know if the Disease will terminate by a crisis or by resolution.
7. On Critical Days.
8. ' That the Critical Symptoms appearing in the commencement are unfa-
vourable.
9> How to judge beforehand of a future crisis.
10. How to recognise a present crisis.
H* How to know whether a past crisis be favourable.
^2. On Pulses.
13. On the Alvine Evacuations.
14. On the Indications from the Urine.
15. On the Indications from the Sputa.
16. Diagnosis and Cure of Ephemeral FeYen.
17. Diagnosis of Putrid Fevers.
18. Treatment of Putrid Fevers.
19. On the Diagnosis of Tertians.
20. The Cure of Tertians.
21. Cure of Spurious Tertians.
22. Diagnosis of Quartans.
23. Cure of Quartans.
24. Diagnosis of the Quotidian Intermittent.
25. Cure of the Quotidian.
26. On the Fever Hepialus, and Rigor without heat.
27. On Continual Fevers.
130
28. Cure of Synochous Fevers.
29. Diagnosis of Ardent Fevers.
30. Cure of Ardent Fevers.
31. On the Diagnosis and Cure of Fever connected with an Erysipelatous
affection.
32. Diagnosis of Hectic Fevers.
33. Cure of Hectic Fevers.
34. On Semi-tertians.
35. On Epidemic Diseases.
36. On the Plague, from the Writings of Ruffus.
37. On those that are seized vrith Syncope from a collection of crude
humours.
38. On those that are seized with Syncope from thin humours.
39. Concerning the other causes of Syncope.
40. On Pain.
41 . On Melting or Colliquative Diarrhoea
42. On Watchfulness in Fevers.
43. Cure of Somnolency.
44 . Cure of Headach in Fevers.
45. On the care of those things which relate to the Stomach.
46. On Inordinate Cold and Rigors in Fevers.
47. On Sweatings.
48. On Cough in Fevers.
49. On Sneezing.
50. On Loss of Appetite.
51. On Inordinate Appetite.
52. On Canine desire of Food.
53. On Thirst.
54. On Roughness of the Tongue.
55. On Nausea.
56. On Vomiting of Bile.
57. On Singultus, or Hiccough.
58. On Looseness and Constipation of the Bowels in Fevers.
59. On Bleedings at the Nose.
60. On Fainting, or deliquium animi in Fevers.
61. Cure of Ulceration over the Os Sacrum.
PAULUS iEGINETA.
BOOK SECOND.
I.— 0» Fevers J from tite Works of Galen and several others.
After having treated of those things which relate to the preserva-
tion of health, we now come to the treatment of persons already in
disease, beginning with homogeneous disorders as being the most sim-
ple. These are what are called fevers. Wherefore, using principally
Oribasius' Epitome from the works of Galen and several others on
this subject, we shall add a few things omitted by them.
II. — Of the principal Considerations to be inquired into with
regard to Fevers,
The first thing to be considered is, whether the disease will
prove fatal or not ; then, if it is not to prove fatal, whether it will
be acute or chronic (these considerations apply to other great dis-
orders) ; and, third, whether it will come to a sudden crisis (which
is peculiar to fevers), or be resolved locally.
III. — From Cralenj what to call the Commencement of the
Disease,
As headach is not the same complaint as fever, so neither are
iQsoninolency, loss of appetite, heaviness of the whole body, and a
^se of lassitude ; and yet each of these symptoms, although differ-
ent from fever, announces its approach. A fever setting in, and
^ore especially in an acute manner, cannot escape our notice, nor
e^en that of a person unacquainted with these matters. Or, if we
should suppose that it might escape us, I should wonder if the
k2
132 PAULUS ^GINETA.
patient himself could be ignorant of it for more than an hour.
Wherefore I call that time the commencement of the disorder,
•when those beginning clearly to be affected with the fever first be-
take themselves to bed.
IV. — How to know whether the Disease mil prove fatal ornot.
These are fatal symptoms : a deathlike countenance, sharp nose,
hollow eyes, and the other symptoms described by Hippocrates,
when they do not proceed from watchfulness, or evacuation, or want
of food ; also, intolerance of the light, shedding tears from no exter-
nal cause, and the eyes not retaining their proper expression, the
one eye appearing less than the other, or the white of the eyes be-
coming red, or livid, or black, or turning muddy ; and the white of
the eyes appearing during sleep, the eye -lids not being closed, un-
less this symptom proceed from a great evacuation, or from habit.
Likewise grinding the teeth, a state of delirium, picking at flocks of
wool, or bits of chafl^, are not favourable. Attention should also be
paid to the patient's mode of lying. To lie supine, as it were, in a re-
laxed state, and to sink downwards in bed, indicate the extremity of
weakness. It is still worse to have a cold respiration at the mouth
and nostrils; and a pulse obscure, dense, and intermitting, and profuse
sweatings with syncope are most mortal symptoms. If all these
symptoms or even more appear, or if they be fewer in number but
strong, and if they be without any favourable ones, death is inevit-
able. Tlie breathing free, pulse natural, soundness of intellect, being
disposed to take whatever food is administered, the appearance of
countenance and mode of reclining like those of persons in health, —
all these symptoms are favourable and prognosticate recovery. In
short, whatever symptom is contrary to the natural state indicates
an unfavourable, whereas what is corresponding indicates a favour-
able termination. Concerning the prognosis from the urine, alvine
discharges, and sputa, we will speak soon.
V. — How to know if the Disease will be of long duration.
The duration of the disease may be ascertained from four things —
from the movement of the disease itself, from the habit of the pa-
tient, from the pulse, and from the species of the fever. From the
movement of the disease thus : if the four periods of a particular
paroxysm have passed over quickly and in the least possible time,
the disease will be an acute one, the furthest bound of which will
be the seventh day, and generally will come to a crisis on the
fourth. If the periods of the first paroxysm occupy more time but
do not exceed twelve hours, the disease will still be an acute one,
which will terminate within the fourteenth day. If it extend
longer, so that the commencement and augmentation of the pa-
roxysm alone occupy a longer period than a day or a night, such a
BOOK SECOND. 183
disease will prove a long one. If the disease have no particular
paroxysms, but consist of one continued paroxysm from beginning
to end, as in synochous fevers, even in this case you may call the
disease an acute one. It may be judged of from the habit of the
patient : thus, if the face and the rest of the body are already con-
siderably reduced, an acute disease is indicated ; but if wholly unre-
duced, a chronic one ; for a great collection of offending matter is indi**
cated, which will require a length of time for its concoction. It may
be judged of from the pulse : thus, a great, strong, quick, and dense
pulse, indicates an acute disease, but the contrary a chronic. From
the species of the fever, inasmuch as hot and ardent fevers indicate
an acute, whereas gentler, and, as it were, smothered fevers indicate
a chronic one.
VI. — How to know if the Disease tvill terminate by a Crisis j or
by Resolution.
This may be ascertained from what has been already said, namely,
the species of the fever and its duration, and perhaps from the
species of the fever alone. For hot and ardent fevers are of short
duration, and have usually some cntical evacuation ; whereas the
gentler prove more chronic and terminate for the most part by ab-
scess. From what has been said, it appears that we may prognosti-
cate not only when the disease will come to a crisis, but also how it
will terminate ; for acute diseases generally terminate by evacuation,
and the chronic by abscess.
VII. — On Critical Days,
Op the critical days some terminate the disease frequently,
faithfully, well, completely, clearly, obviously, and others con-
tnoywise. But the 13th is known to possess an intermediate
character. Some of these are such as to prove critical if they ex-
perience even the most moderate impetus of nature, such as the 7th
and 14th ; whilst most of them prove critical in violent commotions
of the system but not otherwise. Neither are the favourable all
equally favourable, nor the unfavourable all equally unfavourable ;
nor is their favourableness and unfavourableness according to any
order. Those in the first rank of favourable days may be arranged
tbus : the best of all are the 7th and 14th, next to them the 9th,
and nth, and 20th ; and near to them the 17th and 5th, after these
the 4th, after it the 3d and 18th. — Opposed to them, of the second
rank are these. The worst, which proves obscurely critical with
(langer, and is as it were diametrically opposed to the 7th is the 6th.
Near to it are the 8th and 10th, after these the 12th, 16th, and
19th. Intermediate between these is the 13th, being neither so
ol^ectionable as those of the second rank, nor so favourably critical
as those of the first. The critical days then are thus arranged
134 PAULUS iEGlNATA.
according to their degree by Galen. Numerically thus : the favour-
able are the dd, 4th, 5th, 7th, 9th, 11th, 14th, 17th, 18th, 20th;
the unfavourable, the 6th, 8th, 10th, 12th, 16th, 19th; the inter-
mediate, the 13th. Some of the critical days give information con-
cerning the others, and are hence called Indicatory by Hippocrates,
because they indicate the crisis that is to happen on another critical
day. Thus the 4th indicates a crisis on the 7th, by inducing sweats,
perspirations, or some such particular evacuation, or by displaying
certain signs which had not formerly taken place, or some symptoms
of concoction. Galen says, that the 4th is indicatory of the 6th, al-
though it be unfavourable, as the 1 1th is of the 14th, and the 17 th of
the 20th. Until the 14th day the crises are the most decided, next to
these until the 20th, — from the 20th to the 40th they gradually lose
their decided character. Of these, the first in degree are the 27 th, 34th,
and 40th, after which are the 24th and 3 2d. The other numbers
intermediate between the 20th and 40th are indeterminate, and those
after the 40th are not properly critical, as they terminate diseases
by concoctions and abscesses rather than by crises. Hippocrates
seems entirely to disregard all those after the 40th day, yet he
enumerates the 60th, 80th, and 100th. After these, he says that
some diseases prove critical in seven months, some in seven years,
and others as it would appear in twice or thrice seven years.
VIII. — That Critical Symptoms appearing in the commence-
ment are unfavourable,
Thb signs of concoction are never unfavourable, for concoction
always takes place when nature prevails, and therefore the signs of
it are always favourable. But the critical signs may sometimes ap-
pear unfavourably, owing to the crisis partying of a double cha-
racter (as was said with regard to the critical days), being sometimes
favourable and sometimes unfavourable. They ought not therefore
to appear at the commencement, nor during the increase of the dis-
ease, but after its acm^, at which time nature is prevailing over the
disease.
IX. — How to judge beforehand of a future Crisis.
If the paroxysms increase in violence, and occur earlier and
become much stronger; if they invade on the third day; and
if symptoms of concoction appear in the urine, alvine discharges,
and sputa ; the disease will certainly soon come to a crisis. If the
attack is slow, and if the paroxysms occur at the same hour every
day, you may expect that the crisis will not take place till after ft
longer time. And those fevers which make their attack with,
rigors cannot terminate until the rigor abate ; for until that oc-
cur it is impossible for the disease to have attained its acm^, and
therefore much less is it reasonable to expect that it is upon the
decline.
BOOK SACOND. 135
X. — How to recognise a present Crisis,
Rs8TLB88NB8s precedes every crisis, and if the crisis be to take
place by day, it will occar by night, or if the crisis be to take place
daring the night, it will occur by day. Then certain symptoms sa-
pervene, such as headach not previously occurring, sympathetic
pain of the neck, retraction of the hypochondrium, sudden difficulty
of breathing, and other dangerous symptoms which did not mani-
fest themselves before. And if, when these occur, the pulse instead
of sinking is increased in magnitude and becomes stronger, and the
critical day approaches, and if it be one of the favourable, you may
not only anticipate a crisis but also a good one. And be not then
alarmed if you see the patient become delirious and disturbed, for
these are indications of the humours being carried upwards ; in like
manner as certain other symptoms indicate their being determined
downwards, such as pain in the bottom of the belly, gripes about the
navel, pain in the loins, borborygmi, and other similar symptoms.
In addition to these, if the patient was accustomed to have a hae-
morrhoidal discharge, and if the period of it be at hand, and in like
manner with respect to the menstrual discharge (if the patient be a
woman) it is not unlikely that the crisis may take place by such an
evacuation. — And a critical sweat is recognised by a precursory
moistness of the skin (especially if occurring upon one of the days
called indicatory), and by openness of the pores. From these you
may recognise crises by evacuations upwards. For, in addition to
the aforesaid, you ought to examine the face of the patients, and
whether there be palpitation in any part, or throbbing of the tem-
poral arteries ; or if the cheek, nose, or eye be redder than usual,
you ought the rather to anticipate the coming crisis ; but if they shed
tears involuntarily, or fancy that they see sparks of light, and con-
stantly carry their hands to their nose as if to rub it, then indeed
you may see not only an approaching but a present flow of blood .-^
Por when they rub it once or twice the ^blood straightway breaks
forth. Pungent pain at the stomach, and trembling of the under-lip
often indicate a crisis by vomiting. These considerations are suf-
ficient, but to them may be joined the age and constitution of the pa-
tient, as strengthening the anticipation ; to which may be a(fded, the
season of the year and the present constitution. For if the patient
1)6 a child, or otherwise by nature warm and full of blood, you may
still more form this anticipation ; or if formerly when in health or
disease, as we remarked before, an evacuation of blood appeared, this
circumstance alone may be sufficient to make you expect an he-
morrhagy. And if the season of the year be summer, or, if not sum-
mer, if the present state of the weather be hot, and if the patient
had often experienced a crisis at that season by hemorrhage, if the
body be plethoric, if there is retention of the customary evacuations,
all these things ought to strengthen your expectations. In like man-
ner you ought to judge of the other evacuations. Or, if none of these
sirmptoms should appear, but if there be uneasiness occurring on one of
136 PAULUS iSGINSTA.
the critical days after the 20th ; or if, when the disease is at its acm^,
pains should seize certain joints, or near the ears, or in other parts ;
or if not pains, but local sweats should occur unceasingly in any
part of the body; then indeed you may expect a crisis to take place by
abscess, and in that part where the sweats, pains, or swelling oc-
curred.
XI. — How to determine whether a past Crisis be favovrable.
If a proper evacuation takes place after the concoction, and the
fever is resolved by the critical evacuations ; if the patient is freed
from all other symptoms ; if his colour has improved in proportion
to the evacuation ; if his pulse has become more regular, and his
strength better ; and, what is the most salutary symptom of all, if
these are accompanied by repose of the constitution, this may be
pronounced to be the best possible crisis. If any of these be want-
ing, the goodness of the crisis will diminish proportionally.
XII. — On the Pulse^ from the Works of Galen,
The pulse is a motion of the heart and arteries, accomplished by
a diastole and systole. Its use is two-fold ; for, by the diastole,
which is, as it were, a distension and expansion of the artery, the
cold air enters, ventilating and resuscitating the vital power, and
hence the formation of the vital spirits ; and by the systole, which
is, as it were, a falling down and contraction of the circumference
of the artery towards the centre, an evacuation of the fnliginoua
superfluities is produced. The arteries themselves are oblong hol-»
low vessels like the veins, but consist of two coats, in order to fit
them for the afore-mentioned motion, and because they have to
contain blood and spirits. They arise from the heart, and are
distributed to all parts of the body ; and, therefore, all the arteries
pulsate in a similar manner, and like the heart, so that from one
you may judge of all the rest. But the motion of all cannot be
equally well observed ; for those which are situated in parts that
are not fleshy may be easier felt than those in fleshy parts. Nor is
any one more conveniently situated for being felt than the one at
the wrists. The First kind of pulses is in regard to the time of
their motion, as observed in systole and diastole. Their differences
are, the quick, slow, and moderate ; because every body which is
moved must be moved quickly, slowly, or intermediately, as to
time ; that is quick which is moved over a great distance in a short
time ; that is slow which is moved over a short distance in a long
time ; and that is moderate, whose motion is intermediate. The
Second kind of pulses is in regard to the extent of the diastole.
For, since every body has three dimensions, length, breadth, and
depth, and an artery is a body, it follows, that an artery must have
these dimensions. When, therefore, an animal is in its natural
BOOK SECOND. 137
state, you will find its arteries dilated moderately every way ; but
when not in its natural state, its dilatation will be deficient, or exceed
according to some one of its dimensions. In calculating this, you
must remember the natural state of the pulse ; and if it is found to
exceed in breadth, you must call it broad, if in length, long, and if in
depth, high, or deep. It is clear, that the opposites to these, or those
that are deficient, are the narrow, short, and low. And with regard
to those which are altered from the natural state in all their dimen-
sions, that which is every way diminished is called small, and that
which is every way increased, great. The Third kind is with re-
gard to the tone of the vital strength. The varieties are three, the
strong, the tpeak, and the moderate. The strong is that which strikes
the finger of the physician strongly, and the weak, feebly and faint-
ly ; while the moderate is intermediate between them, and is held
by some to be the natural one ; for, that a strong pulse is occa-
sioned by passion and baths and is not natural. In reply to which,
Galen contends, that a pulse, rendered stronger by non-natural
causes, soon undergoes a change ; and that, therefore, a strong
pulse, which does not readily change, is natural and moderate.
The Fourth kind is in regard to the consistence of the instrument,
I mean the body of the artery. In this respect there are three dif-
ferences ; for the artery is either harder than natural, and is called
a hard pulse, or softer, and is called a soft, or intermediate, and is
called in this respect moderate. The Fifth kind is in regard to the
contents of the artery ; and their dififerences are, the full, the empty,
and the moderate, since every vessel must be full, empty, or mo-
derately full of liquids. A fall pulse, then, as Archigenes defines it,
is one which indicates an artery that is completely fuU, and the im-
pression of which is, that it is distended with fluids ; and an empty
one conveys an impression, as if its contents were full of bubbles
of air, so that the finger, when pressed upon it, seems to fall into
an empty space. These five kinds of pulses regard one motion of
the artery. And since the quality of the heat in the heart may be
more apparent than usual in the artery, some have hence formed
a Sixth kind of pulses. Of the other kinds, whether they are in
regard to one or more pulsations, they derive their character, either
from the time of rest, or the rhythm, or their equality and inequality,
or their regularity and irregularity. The kind, then, in regard to
the time of rest, which is the Seventh in order, is divided into the
dense, the rare, and the moderate. And, since an artery has a
double motion, composed of two opposite motions, it must of ne-
cessity have two seasons of rest, the one after the diastole before
the systole, the other after the systole before the diastole, which
many people affirm cannot be perceived ; and, therefore, the inter-
val of rest between two motions has been chosen. When, there-
fore, there is a long interval of rest, the pulse is called rare, when
short, dense, and when intermediate, moderate. The Eighth kind is
in respect to rhythm. Rhythm, then, in general, is the ratio and
proportion of one time to another. In regard to the pulse, it is,
acceding to some, the ratio of the time of motion to the time of
138 PAULUS iEQlNETA.
rest, as of the systole and diastole, to the intermediate time of rest ;
but, according to others, it is the ratio of a time of motion and rest
to another time of motion and rest, or of motion to motion.
Of rhythm, then, there are two varieties, the proper, and the
improper rhythm. Of the improper, there is a threefold difference ;
first, when there is a slight departure from rhythm ; second, when
there is a greater; and, third, when there is no rhythm at all.
Thus, for example, in a child, if his pulse has the rhythm of child-
hood, it is called its proper rhythm, if it has that of an adult, it is
said to be an improper rhythm, or if it preserve no ratio at all, it is
said to be without rh3rthm.
The Ninth kind of pulses is found in all the other kinds already
mentioned ; namely, that which regards equality and inequality,
which may be remarked either in one pulse, or in many, which last
is called the Systematic, and of which we must speak more clearly.
An equal pulse, then, is that which is alike in order, as regards
magnitude, strength, frequency, and certain other, or, indeed, all
its other characters. The unequal pulse, is that which is unlike in
order. For, if all are alike, as, for example, all deficient in mag-
nitude, such a pulse is called equal. But if the first, second, and
third appear alike, but the fourth unlike, it is clear that such a
pulse is unequal as to magnitude. Of this kind are the intermitting
and the intercurrent. For not only after one or more great pulsa-
tions may one smaller occur ; but sometimes this motion is wholly
wanting, and the pulse is said to intetmit. The other kind, the in-
tercurrent, is the opposite to this ; for, when we are expecting an
interval of rest, a supernumerary pulsation, as it were, occurs.
When the second is a little smaller than the first, and the third than
the second, and the fourth than the third in like manner, and so on-
wards, such pulses are called sharp-tailed or myuri, deriving their
names ^om figures terminating in a sharp point. Such as are al-
together diminished, and never cease from this state, terminate in
a total loss of motion, and aie called failing, or fainting myuri.
There are two varieties in respect to those which fail, for some of
them persevere in that state of smallness in which they terminated,
whilst others attain again their original magnitude, or nearly so,
or perhaps a greater, and these are called recurrent myuri. Pulses
also are called myuri, from their inequality in regard to one pulsa-
tion, concerning which we will speak presently. And this is the
nature of that inequality of pulse, called Systematic. But that
which takes place with regard to one pulse, or one part of an artery,
or more, as perhaps with regard to motion, for the inequality is ob-
served on one part of the artery, when the motion of the artery
upon the finger begins one way and terminates another, beginning
quicker, and terminating slower, or reversely. This happens in a
threefold manner, the motion either remaining constant, or being
interrupted, or recurring and beating double, as it were. If, then,
remaining constant and uninterrupted, it should change from quick-
ness to slowness, or conversely, such a pulse is said to be, and is of
unequal velocity. But if, after being interrupted by an interval of
BOOK 8£COND. 139
rest, it again appear quicker, it is called the goat^Uap or dorcadissana,
the term being derived from the animal dorcas, which, in jumping
aloft, stops in the air, and then unexpectedly takes another and a
swifter spring than the first. But, if after the diastole it recur, and,
before a complete systole take place, strike the finger a second
time, such a pulse is called a reverberating one, or dicrotos, from its
beating twice. You may see such a thing take place upon a stithy,
when a hammer, swung by the hand, first strikes the stithy, and
afterwards, recoiling from the re-action of the stithy, strikes it of it-
self a second or third time. And not only may an inequality as to
the time of motion take place as to one pulsation in one part of an
artery, but also in regard to the strength of the power ; not so,
however in regard to the extent of dilatation (for it is impossible
that the same pulse in the same place should be great and small at
the same time), nor in regard to the other kinds of pulses. But in
different places different parts of an artery may exhibit a double
inequality in one pulsation. For the motion may continue constant,
and be swifter at one finger and slower at another ; or, it may in**
termit, and one finger may perceive it, and another not. And also,
in r^ard to the extent of the diastole, the same inequality becomes
apparent in diffident places. Of this kind are the myuri, diminish-
ing once and again at one pulsation ; for, if at the inner finger the
pulse should be great and swelled up, but under the external at the
thumb of the patient it appear smaller, such a pulse is called myn-
rus, from its resemblance to the tail of a mouse — or meiurus, from
its being diminished like a tail. But, if the pulse appear great, and
swelled under the middle finger, but smaller on each side, Archi-
genes called this pulse innuens et circumnuens, i.e. the declining, and
the declining on both hands, wishing to mark the smallness of the
diastole, with the declination, as it were, of the two extremities ;
for these parts do not appear as if they were cut short, but as if
they were bent in and a little contracted on each side, and hence
the pulse is curtailed (myurus) on both sides.
And when the inequality as to magnitude takes place at different
times, such pulses become undulatory and vermicular. And if irre-
gularity of position be joined to them, they are called spasmodic
and vibratory. Let us begin with the undulatory, in which the
whole artery is not dilated, at the same time, according to the same
inequality, but this part of it first, that second, that third, and that
fourth, the motion continuing constant like the swelling of the
waves. And some have the wave carried straight forward, some
obliquely ; some have a sufficient altitude in a short expansion as
to length, and some conversely ; some have a broad, and some a
narrow, and they have the like inequality in regard to quickness
and strength. When the undulatory is wholly diminished in size,
it is called the vermicular, which resembles the motion of a worm.
As the undulatory pulse, when it goes on diminishing, terminates in
the vermicular, so in like manner does the vermicular in the ant-
like, when, most <^ its motions being lost, it terminates in one, and
it a very- small motion. It is called formicans from its resemblance
140 PAULU8 ifiGlNETA.
to the ant {formica), on account of its smallness and kind of mo-
tion. The ant 'like or creeping pulse (called formicans) is very
small, there being none smaller than it ; and, in like maimer, it is,
of all others, the most indistinct and dense, but is not quick as
Archigenes supposed. Nearly allied to it is the hectic. For, as
there is a hectic fever, so is there also a hectic pulse, which under*
goes little or no variation, but remains always the same as at first,
contracted and never expanding, the whole habit being turned into
disease. The spasmodic pulses appear as if they were dragged,
stretched, and drawn by the extremities, conveying the sensation of
a stretched cord. But no such thing takes place in the vibratory;
for, in them the dilatation is greater, as if different parts of the
artery were carried upwards at one and the same time. They may
be resembled to darts, which, when thrown with force, are carried
along with a vibratory motion. The pulse is serrated when part
of the artery seems to be dilated, and part not ; the artery itself
also appearing to be harder than natural. This pulse has some of
the characters of the vibratory, and is quick and dense, but not al«
ways great. In addition to those mentioned, there is a tenth kind
of pulses arising from inequality, namely, relating to regularity and
irregularity. The unequal pulses being divided into those which are
alike as to periods, and those which are wholly unlike, the regular
and irregular are formed according to each of these divisions ; from
the equality of periods, the regular is formed, and from the entire ine-
quality the irregular. The equal pulse is also always regular (since
consequently we call it alike) ; but the unequal is not altogether irre-
gular, for, supposing it to have no equality, and yet to preserve a cer-
tain period, such, for example, as to extent of diastole, if there are
two great and one small, then again two great and one small, and so
on successively, such a pulse would be called anomalous, that is to
say, unequal, but regular. But, if it not only had no equality, but
likewise no order in its inequality, such a pulse would be not only
unequal, but also irregular, and in like manner with regard to the
other kinds. Of the irregular, some are altogether so, observing no
period whatever ; others are indeed regular as to periods, but, having
no continued order, they may, in this respect, be called irregular*
but in so far they observe a certain period regularly, they being regu-
lated as to their periods. As if, for example, there were two great
and two small, then three great and three small, and four great and
an equal number small ; and, returning again, two great and two
small, three great and as many small, and so on in like manner.
It is to be remarked, that, of all the other opposite kinds, there is
one intermediate between the two extremes, but that there is none
between the equal and unequal, and the regular and irregular, un-
less you choose to call the one which is regular as to periods the
medium between the regular and irregular. And the intermediate
pulses of all the other kinds are the natural, except that which
relates to strength and weakness, as we showed. But, in those
we have been describing, the equal alone is the natural, and all the
others are not natural, namely, the unequal, the regular, and the
BOOK SECOND. 141
irregular. These are all the kinds of pulses and their generic dif-
ferences. Some add two others to these, the one in regard to the
position of the artery, according as it seems to he carried upwards
or downwards, to the right or to the left, and the other in regard
to the times of expansion. But these we treated of along with the
uidulatory and the vihratory. And we, for the sake of hrevity,
have only delivered the simple varieties ; hut, from what has been
said, one may easily cmnect them^^ and discover those which arise
irom their combinations.
The causes affecting the pulses are next to be treated of,
with which is connected the prognosis from them. We shall
begin with those which respect magnitude, because it is more ob-
nous than the others. A great pulse is produced either by some
argent necessity, such as an excess of heat in the heart re-
quiring refrigeration, and as it were ventilation from without ; or
it may arise from leanness of the body, as we shall soon show.
The excess of heat is occasioned either by natural causes, such as
the ages of manhood and youth, or simply a hot season, place, or a
warmer temperament; or by non-natural causes, such as the air
which surrounds us being hotter than common, hot baths, exercises,*
food, wine, heating medicines ; or by preternatural causes, such
as a hot intemperament, putrefaction of the fluids, passion, or the
like. You may judge of these classes of pulse from the following
observations. Those which are natural are permanent and not
rery susceptible of change, whilst the others readily change, so that
often while you examine them, or generally after a very short time,
they will altogether alter. A pulse also which owes its greatness
to a hot bath has softness for an accompaniment ; and hardness
is generally combined with greatness proceeding from a hot in-
temperament, especially when combined with dryness of the sys-
tem. Those who have undergone moderate friction or exercise
have a pulse intermediate between hardness and softness ; but they
have the parts about the chest warmer than natural, which is the
case also with those in a passion. Those that are influenced by
food, the use of wine, or rage, have vehemence joined to greatness.
Those who wish to conceal anger, or something which they have
done without permission of the physician (such as if a person has
taken a heating medicine, and wishes to conceal it from the physi-
cian, who inquires about it while he feels the pulse), in such per-
sons, a manifest inequality is joined to greatness. To the discovery
of this state, other considerations may contribute, such as the habit
of the patient, as if he appeared to be fond of taking medicines, or
his disposition, as if it be bad, and cunning at concealments. A
pulse which is great from putrefaction of the fluids has joined a con-
traction more hasty than natural to its greatness. To form a great
pulse, an urgent necessity is not alone sufficient; but the vital powers
must also contribute, and a condition of the instrument or artery in-
termediate between hardness and softness. When the heat, therefore,
is increased in the heart by any of the above-mentioned causes, in
the first place, the pulse becomes great, and, the greatness not being
able to supply the want, quickness is straightway joined to it ; and,
142 PAULUS iEGINETA.
if that is not sufficient, density is superadded. But small, slow,
and rare pulses are formed by the opposite causes. But, when a
change first takes place from a great, quick, and dense pulse to
their opposites, namely, when the necessity is at an end, the first
character of the pulse is not the first that leaves it, but it loses first
that which it last acquired, becoming first rare, then slow, and last
small. But, if the slowness and smedlness should go on increasing,
the rarity will again change to density, in order that the necessary
want may be supplied. Such are the causes of greatness, quick-
ness, density, and their opposite pulses. To these we shall con-
nect the alteration of the pulse in regard to one dimension only.
Breadth alone then is increased, principally by a redundancy of
humidity, either natural, or from external causes, as loftiness is oc-
casioned by the softness of the instrument, assisted by the vital
power ; but length is rendered apparent, by the dr3mess and melt-
ing of the surrounding flesh, the other dimensions being contracted.
For an artery cannot, in fact, become longer than natural ; and this
ought more properly to be called the lean pulse, as the opposite one,
namely, that which is increased only in breadth and depth, should
be called the fat. The pulse sometimes falls under the opposite
characters to this, when it is restrained as to any of its dimensions,
and appears low, narrow, and short, when it is not so in reality,
but seems so, owing to the thickness of the fat, flesh, or membranes
which press upon it. Sometimes, too, the whole seems small,
when it is not so in reality ; and feeble in like manner. And what
do I say? Sometimes an asphyxy, or complete loss of pulsation,
hath seemed to take place over the whole arteries, when there is
no such thing in reality ; and this has happened, more especially to
those who have felt them carelessly, when the motion, being really
indistinct, escapes notice, owing to the quantity of flesh ; for it is
impossible that a complete a8ph3nEy could take place while the man
is alive. In like manner, again, in the emaciated, small pulses ap-
pear great. When, therefore, the body is greatly wasted, the ar-
tery which runs along the spine has often been felt by those who
touch the abdomen, and also the pulses in members which be-
fore used not to be felt. Wherefore, we must attend to all circum-
stances, that we may not be mistaken in our diagnosis. A strong
pulse is occasioned by the force of the natural faculty, when not
counteracted by any other cause, such as the want being faint,
or from hardness of the instrument. But a feeble pulse may arise
from weakness of the natural powers alone, although no other causes
contribute. For a strong pulse stands in need of all the other
causes for its formation ; but the feeble is produced by weakness
alone. The originally strong pulse accompanies moderate ages,
seasons^ j^aces, and temperaments ; but the feeble the immoderate.
A pulse changing from feebleness to strength is formed by the
vital faculty growing strong, from a preceding state of debility. It
is strengthened either by things within the body, such as concoc-
tion of the fluids, or an excretion of them, or passion ; or by ex-
ternals, such as wines, food, exercises, and whatever will rectify
BOOK SECOND. 143
the intemperament. The natural powers are weakened by want of
food, watchfulness, immoderate evacuations, grief, cares, and more
especially pains inducing syncope, and whatever forms an intem-
perament. Some inexperienced persons have thought a hard pulse
strong, but a person of experienced understanding and touch will
not mistake them ; for a strong pulse, being mostly accompanied
with greatness, is swelled up to loftiness and strikes the finger
forcibly ; but the hard does not admit of greatness, on account of
the unyielding state of the artery. Wherefore, a pulse becomes
bard, owing to the hardness of the artery. This is occasioned by
immoderate cold, or dryness, or tension proceeding from inflamma-
tion or spasm. To the hardness are straightway joined smallness,
quickness, and sometimes density instead of greatness, owing to
the exciting want. A soft pulse follows a humid state of the ar-
tery. An artery is rendered more humid by things not preternatural,
SQch as more liquid food, immoderate baths, much sleep, a more
abundant diet, and hilarity ; and by preternatural causes, such as
coma, lethargy, dropsy, and the other pituitous affections. A full
pulse indicates an abundance of fluids, or plethora from food, or
from drinking wine, as the empty on the other hand indicates de-
ficiency of food or evacuation. When the body of the artery feels
warmer under the finger, tiiis indicates great heat in the heart,
while the rest of the body is cold, or a certain spasmodic state of
the arteries, which are warmed by the violent motion. Archigenes
says, that the place of the artery will particularly be found warmer
in catochus, and in those who are about to be affected with somno-
lency. With regard to rhythm, when the ratio of the times of
motion and rest is equal, it indicates a proper temperament of the
body, or no great departure from it, as in early age, and the otherwise
well-regulated bodies. But, when the time of rest is greater than
that of motion, this indicates that heat prevails, as in adults and
those of the adjoining ages ; as, in aged bodies which are entirely
eold, the time of motion is greater than that of rest. It is to be re-
marked, that inequality in regard to rhythm, being the measure of
that as to quickness and density, this holds the place, as it were, of
the materiel to the rhythm.
The intermittent and intercurrent pulses take place when the
powers are oppressed, and, as it were, borne down ; but the inter-
current indicates a lesser, and the intermittent a greater injury.
And, in general, that state in which the powers are oppressed and
borne down, changes the pulses to inequality and irregularity in
every other respect, and also in regard to strength and greatness.
The pulses called myuri, being shown to be of two kinds (for they
are found either in that inequality called systematic, or in regard to
one pulsation), the failing or fainting evince the last prostration of
the powers ; but, when they return, or are recurrent, they indicate
that the powers are weak, but that they are struggling, contending,
and have not yet submitted. As to the myuri, in regard to one
pulsation, called the failing, and the failing on both hands (innuentes
et circumnuentes), these happen to persons who are gradually wasted
144 PAULUS iEGINETA.
by inflammations not yet resolved, and to those who waste from
whatever cause* the bodies around the arteries being melted down.
Pulses of unequal velocity, and those called dorcadissantes or gout-
leap, principally accompany febrile heat. But, if the pulse be faint
at the commencement of the diastole, and increase in velocity to-
wards the end and beginning of the systole, this indicates that
putrefaction is prevailing, nature hastening on the discharge of the
fuliginous superfluities. But if, on the other hand, it be faint at
the commencement of the systole, and rather make speed towards
the diastole, you may be sure that the heat is prevailing, and long-
ing for refrigeration. These in fever are, for the most part, ac-
companied by density, and sometimes greatness, if the powers he
not restrained by the hardness of the instrument. When the hard-
ness of the artery increases, and the powers are not weakened, the
double or reverberating pulse is formed. The undulatory pulse most
commonly attends the more humid aflections, such in particular as
anasarcous swellings, lethargy, and peripneujnony. When the
powers of life are beginning to fail, but are still making a faint
struggle, the undulatory pulse sinks into the vermicular ; but, when
they decline to their lowest ebb, this last passes into the ant-like
or formicans. The hectic particularly attends those in consump-
tion and marasmus. The spasmodic pulse takes place when the
origin of the nerves is suffering from some inflammatory aflection,
as in phrensy and acute attacks of epilepsy, when those aflfected
with them die while they are yet warm, contrarywise to those in
syncope, for they are alive after they have become cold. The
clonodic or vibratory pulse takes place when the wants of the system
require a great diastole, and the vital powers are sufficient for that
purpose, but are opposed by the body of the artery ; which, from its
hardness, cannot be expanded to a large diastole, as happens in
great inflammations and chronic obstructions. The serrated pulse is
indicative of inflammation, and particularly in some tendinous part. It
is no less so of pleurisy, and when slight, it indicates that the inflam-
mation is gentle, and easily to be concocted; but when intense, that it
is severe and of difficult concoction, and will be attended with urgent
danger, if the powers be weak, or, if they be strong, that it will be
slowly concocted, for it will either terminate in empyema, or a con-
sumptive marasmus will supervene. One ought also to know, that
irregularity of the pulse commonly accompanies its inequalities ; for
you will rarely find an unequal pulse orderly. Wherefore, the
lesser constitutional injuries occasion unequal and regular pulses,
but the greater, the unequal and irregular.
These are the simple causes of the pulses and their prognosis,
and from them the compound, as we stated when treating of their
differences, may easily be discovered.
XIII. — On the AMne Discharges.
Of the alvine discharges, the best is that which is soft and com-
BOOK SECOND. 145
pact» and is evacaated at the hour which is customary in health.
Such excrement is yellowish, of the proper consistence, and not very
fetid ; for whatever is different from these is not good. That which
resembles in colour the food which has been taken, or is thin, wants
the natural juices, and is passed quickly, is indigested. But that
which is very yellow, if evacuated in the beginning of a disease, in-
dicates that the complaint is of a very bilious nature ; but if after
the acm^, that the body is properly purged. The green is indica-
tive of violet-coloured bile, but the black of black bile, or of adust
blood mixed with it. The livid marks a coldness and considerable
mortification of the internal parts. The oily is indicative of a melting
of the fat in the body ; as the glutinous, which is worse than the oily,
indicates a melting of the parts of the animal. That which is very
fetid indicates no small degree of putridity. With regard to them
all, if the quality of the excrements does not correspond with the
food which had been taken, judge from hence of the affection. Of
all kinds, the worst and most fatal is black, livid, oily, and what is
hastily passed.
XIV. — On the Indications from the Urine.
As concerning the alvine discharges, so also with respect to the
orine ; using that of healthy persons as a rule, we shall hence form
our indications of that of persons in disease. That urine, therefore,
is best, which is nearest to that of healthy persons. Such is that
which is at the same time somewhat tawny and yellow, and which
straightway attains a proper consistence. There are three varieties
of turbid urine ; for either straightway after being voided it deposits
a sediment, or it always remains the same, or it is voided pure, but
sfterwards becomes turbid ; of these, the third is bad, the first favour-
able, the second intermediate between them. That which is wholly
unconcocted, being altogether watery, is symptomatic of digestion
bdng entirely gone in the venous system. But when it is passed
frequently, the disease is called diabetes, which is the worst of un-
Qoncocted urines. Next is the thin and white urine, which resem-
Ues water. Nearly allied to these, is another kind of urine, appear-
ing in many diseases, and which is very like to the thin and white.
The palish is next to this. The pale may also be somewhat tawny,
and is concocted in proportion as it partakes of this colour. It
ought,^ however, to be as much different from water in thickness as
in colour, if it is to be properly concocted. But if it preserve ex-
actly its natural colour, and have a white, smooth, equable, and
copious sediment, it is indicative of perfect digestion. A greater
quantity than natural indicates that a crude humour is purged off ;
but if it is somewhat thicker than natural, and has a certain sedi-
ment, it is not then altogether unconcocted. But if it have farinaceous,
scaly, furfuraceous, black, livid, green, or fetid sediments, such urine
is altogether unconcocted and mortal. But urine of a proper colour,
and which at the same time has white, smooth, and equable sedi-
L
146 PAULIJS iEGINETA.
ments, or certain cloud-like appearances, or substances swimming
in the middle, is of all others the best. Of these characters, the
sediment is of the most importance ; next, the substances swimming
in it ; and, third, the cloud-like appearances on its surfttce. In fine,
of those things which float in the urine, the more they subside
downwards so much the better.
XV. — On the Indications from the Sputa.
Such as are somewhat yellow, tawny, frothy, and thin, indicate
only want of concoction, but nothing else positively bad. But such
as are purely yellow, tawny, frothy, green, viscid, round, and
still more the black, are positively bad. For, with the exception of
the blood, whatever of the other humours is unmixed, indicates a
bad diathesis, having its origin in an inflammatory heat. Tiie
bloody sputa are of an intermediate character, but those of yellow
and black bile are unfavourable. The manner in which they are
brought up, ought also to be considered ; for, if they are readily spit
up, it is clear that such are good, whereas the contrary are bad. It is
an indication of complete concoction that the expectoration is unctuous,
white, and equable, and in consistence, neither fluid nor very thick ;
as it is of a complete failure of concoction that is not spit up at all.
If it is indeed spit up, but thin, it is a mark of feeble concoction. If
it is of an unmixed tawny or yellow colour, it is not good. - But if
it is livid, of a violet- colour, or black, it is a most fatal symptom.
XVI. — TJie Diagnosis and Cure of Ephemeral Fevers.
It is a peculiar and inseparable symptom of ephemeral fevers^
that concoction of the urine takes place on the first day ; and a plea-
sant state of the heat is likewise a peculiar and inseparable S3rmpr
tom. After the first solution of the fever, you will have a still
more confident diagnosis; for the motion of the arteries then becomes
similar to that of persons in health, whereas no other fever returns
so soon to the natural state. And it is aho a great mark of this fever,
that the patient bears it well. They are readily seized with this com-
plaint in whom the perspirations are not vaporous, but acrid, as If
containing something fuliginous. Such are they who are of a hot
and dry temperament, and are altogether much troubled with bitter
bile. Those who are seized with this fever from fatigue, should be
rubbed softly with oil and bathed ; but those from dryness, are to be
rubbed less and bathed more. Those from care, grief, watchful*
ness, or anger, are to be bathed, yet not often, but slightly rubbed
with plenty of tepid oil, possessed of little stypticity ;" and bathed
according to habit. Those who have been seized with the fever
from beat, are straightway to be treated with cooling remedies and
more baths, but, by no means, with much oil and friction. The
cooling remedies are to be rose oil, or cold oil of unripe olives, pre-
BOOK SECOND. 147
pared withoot salts. The same are to be poured upon the open of
the head, and the hath used when the fever has passed its acmd. If
a person has fever from cold, he is to be bathed in the decline ; but
if the fever be attended with catarrh, he is not to be bathed until
concoction take place : but those who have fever from a hot cause
are to be bathed while these symptoms are present. Those A-om
cold, are to be warmed moderately, and have the head bathed with
sach applications as the oil of iris and of nard. To those in whom
the fever is occasioned by constriction of the skin, the proper reme-
dies are, baths of tepid sweet waters, attenuant friction, exercises,
and an exhilarating diet. Those in whom the fever is occasioned by
want of food, are to be led to the bath after the decline of the first
paroxysm, and to have plenty of tepid oil poured upon them ; are to
be rubbed most gently, and to remain for the greater part of the
time in the cistern of the warm bath. After coming out and re-
covering their strength, they are to be led again to the bath, and
afterwards get warm water to drink, the juice of ptisan, and some-
times of lettuce ; and are to take of fishes having tender flesh, in
white broth. The common diet in all these cases ought to consist
of things which contain good juices, of easy digestion, and which
will not be restrained within the pores of the skin. Wine should
be given which is watery in appearance and strength. It will some-
times be proper, on the first attack of the fever, to give some
nourishing food, when the fever has been enkindled by an intem-
perament inclining to the hot and dry. Those who have this fever
from inflammation of the glands of the groin, do not require a phy-
sician to instruct them what ought to be done ; for, attending to the
ulcer from the time that the bubo is formed, they take the bath in
the decline of the paroxysm. But they ought to be restricted as to
wine, ontil the inflammation of the groin is resolved, and use a
spare diet.
XVIL— 0» Putrid Fevers.
Thk diagnosis of fevers from putrefaction is formed from observ-
ing that none of the procataratic or exciting causes had preceded ; and
it is peculiar to fevers from putrefaction, that they do not commence
with rigors, being preceded neither by strong heat nor cold ; and
compression of the pulse is also peculiar to them. This is the name
given to the pulse, when in the commencement of the paroxysm it
m very small and irregular. This is a well-marked peculiarity of
such fevers. But the strongest chfu'acteristic of putrid fevers is, the
quality of the heat ; for it is fuliginous so as to prove pungent to the
touch. Want of concoction in the urine and feeble digestion are
also peculiar to them. For, in such fevers, a strong and distin-
guished appearance of concoction in the urine is never to be seen at
first.
l2
148 PAULUS .fiGINETA.
XVIII.— 7%e Cure of Putrid Fevers.
When the powers of the constitution are strong, a person affected
with a putrid fever ought to be bled in the commencement, provided
there be no crudities in the stomach. But when the powers are
weak, or the age of the patient is an objection, you must not bleed.
After the evacuation by bleeding, it will be proper to clear away
the putrid matters by urine, the belly, and sweating. And, if they
have spontaneously been determined towards the stomach, they may
be evacuated by emetics, but otherwise you must not produce an
unnatural irritation. Such things ought also to be selected as will
eflfect the afore-mentioned evacuations without heating or drying,
such as the juice of ptisan, honied water, oxjTnel, apomel, and the
root of parsley. When the belly is not evacuated, an injection of
mulse, with oil, may be given. The body is not to be rarefied before
evacuations ; but, after evacuations, it may be rarefied by means of
an oil possessing a gentle heat, such as that of camomile. At this
season, all the secretions are promoted by drinking of some watery
wine, and using a tepid bath of sweet water. When the strength
of the fever is an objection, you must neither use wine, the bath,
nor rarefying unctions ; but, in such cases, drinking of cold water
is the most suitable remedy, if nothing prevent the use of it like-
wise. But if all the powers are strong, the fever of a very hot
nature, with clear symptoms of concoction, cold water may be given
boldly. But if he is muscular, and the constitution of the air hot
and dry, he will not be hurt by being thrown into a cold bath.
And if the fever is moderate, and the strength good, with symp-
toms of concoction, baths, the drinking of wine, and unctions of a
rarefying nature will be beneficial to such persons.
XIX. — The Diagnosis of Tertian Fevers.
The tertian fever being occasioned by yellow bile, which is set
in agitation, has a considerable rigor in the beginning, which dif-
fers, however, from the rigor of a quartan in this, that the whole
skin feels as if it were pierced and wounded ; but, in quartans, the
attack is accompanied with a strong chill ; and quotidians have no
preceding rigor, they are only accompanied with a chill. But in
tertians, the order of the pulse is regular, and the fever is attended
with strong thirst towards the acme, and burns up the man ; but,
afterwards, the acme takes place, and the heat is equally diffused
every where. If you apply your hand, at first it is met by a strong
and pungent heat, which seems as if carried upwards in the form
ef vapour, but it is soon extinguished under the hand, if it is al-
lowed to remain. And when the person drinks, straightway a hot
vapour in great quantity issues from the skin, announcing a sweat.
But vomiting of bile supervenes, or the belly is loosened, and they
j:ass bilious urine. With these the fever goes off, having compre-
BOOK SECOND. 149
hended not more than twelve hours in one paroxysm. "When,
therefore, it abates within twelve hoars, we call it true tertian ;
when the paroxysm is more protracted, we name it simply tertian ;
and when the paroxysm is prolonged to the utmost, so as to have
but a small interval, we call it prolonged tertian.
XX. — On the Cure of Tertian Fever,
In the true tertian, as being occasioned by yellow bile, we must
dilute and cool, evacuate the defluxions upon the stomach by eme-
tics, and downwards by the belly, and carry them off by urine and
perspiration. The belly, therefore, is to be moved by emollient
clysters, and the secretion of urine promoted by infusions of parsley
aad dill in the drinks. And if symptoms of concoction appear, you
may confidently give wormwood. Apply also baths of warm com-
mon water, and let neither nitre, nor salts, nor mustard be rubbed
upon his body; but let the patient enter them after having had
warm oil poured over his body. There will be no mistake if those
who are fond of baths be bathed twice ; and, if symptoms of the disease
being concocted appear, there will be no harm even if he is bathed
oftener. Until the disease is concocted, wine is to be entirely pro-
hibited ; but when concoction commences, first some thin and watery
wine may be given, and food of a diluent and cooling nature will be
proper ; but honey, mustard, pickles, and every thing heating must
be abstained from. Such was the practice of the ancients ; nor is
it to be wondered at, as these men were more habituated to exer-
cises and a restricted diet ; but now, when order is perverted, the
bile is, for the most part, found mixed with phlegm. Wherefore,
now-a-days, most tertians are either without a rigor, or it is very
slight.* And the mode of cure is also changed ; for, neither does
the bath suit with tertians now before concoction, nor yet a full diet,
except crumbs of bread, eggs, or the like.
XXI. — The Cure of Spurious Tertians.
It does not suit with spurious tertians to bathe at the commence-
ment, nor until symptoms of concoction have made their appearance.
Neither does it answer to give food every day, but every alternate
day will be sufficient. Rest and warm applications to the hypo-
chondriac region agree with them, also broths of easy digestion,
and clysters not very emollient. And if detraction of blood be ex-
pedient, it ought by no means to be omitted. The nature of the
diet ought not upon the whole to be cooling and diluent, but things
of an incisive nature ought to be added. They are particularly be-
nefited by the juice of ptisan, to which have been added pepper,
hyssop, sweet marjoram, and spikenard. Also, add pepper to honied
water, boil, and g^ve it to drink, and likewise every thing which
will promote the secretion of urine, except those things which are
150 PAULUa ^GINETA.
of a very heating and desiccant nature. In particular, after the
seventh day, give wormwood; and many have been benefited by
drinking oxymel, and taking gentle laxatives. A vomit taken with
food answers well with those in whom the affection is chronic.
XXII. — The Diagnosis of Quartans.
The quartan makes its attack with much coldness, as having its
origin from a cold humour, namely, the black bile ; but it is not
attended with ardour and febrile heat like the tertian, neither does
a vomiting of bile . accompany. If, in addition to these, the urine
be thin, white, and watery, the fever certainly is a quartan ; but the
characteristic of a true quartan is a small and rare pulse. They
have their beginning most frequently in autumn, supervening upon
wandering fevers. At that season, intermittents generally assume
the quartan type, although sometimes the paroxysm observes a
longer interval of days.
XXIW.— The Cure of Quartans.
Those affected with quartans are to be treated gently, without
any powerful medicine or evacuation, unless a great fulness of blood
prevail, in which case it may be necessary to bleed. The diet
should be good and not flatulent, and the belly ought to be loosened
by the customary things ; and, if these are not sufficient, clysters may
be used, at first emollient, and afterwards acrid. They must be
prohibited from swine's flesh, and every thing that is viscid and
slowly evacuated, and also from all cooling and diluent articles of
food. Let them use a thin white wine moderatdy wann, also
pickles and mustard. And after an interval of some days, they
should take the composition consisting of three peppers, or that
called Diospoliticus. And if they take every day of pepper alone in
water, they will do well. But if the patient is at the acme of the
complaint, his diet ought to be very light, he should be enjoined to
take protracted rest, and to take care of his bowels by using emol-
lient and laxative things. Next, let him use diuretics ; and if the
symptoms of concoction appear manifest, then he may boldly have
recourse to such as evacuate black humours, and that not once only,
but frequently. Give him also the medicine from vipers, and such
others as are recommended for these fevers, among which is the
well-known and celebrated one containing the Cyrenaic juice.
XXIV. — The Diagnosis of the Quotidian.
The quotidian does not make its attack with a rigor on the first
day, but in progress of time, a chill rather than rigor takes place,
which is, with difficulty, succeeded by heat, and it goes on long in-
BOOK SECOND. 151
creasing. Yet, it does not make those affected hot, nor their respir-
ation frequent and thick, nor does it make them pant or drink cold
water. But they have vomitings of phlegm, and whatever is voided
by the belly, is cold, crude, and watery, in these fevers. And they
have no sweats during the first days, neither have they an intervd
of freedom from fever. Their colour is white and pale ; their urine
thin and white, or thick, turbid, and red.
XXV.— 7%e Cure of Quotidians.
In curing the quotidians, we use oxymel during the first days,
and those things which promote the discharge of urine. And, upon
the whole, the diet ought to be incisive ; but, at its acme, we must
look to the stomach, particularly its orifice. We must also prescribe
an emetic from radishes with food, and phlegmagogue cathartics
in abundance, until it subside.
XXVI. — On the Fever HepiahiSy and the Rigor tvithoul heat.
Thb vitreous phlegm being the coldest of all, if it accumulate in
the body« and remain free from putrefaction, it occasions the rigor
without heat, which is not attended with fever. In those fevers
which are kindled by the humours, it is putrefaction for the most
part which kindles febrile heat. If it become putrid, and that
through its whole substance, which is rarely the case, owing to its
great coldness, it occasions quotidian fever. But when it is half
putrid, and not equally through its whole substance, but some parts
of it being putrid, and others not, it gives rise to the fever called
Hepialus, in which those affected have rigors and fever at the same
time ; for the parts of the humour which are not putrid being scat-
tered through the veins all over the body, occasion rigor ; but the
putrid parts kindle fever. The word Hepialus is either derived
from ^irtoff cikos, I. e. the sea, which is mDd in appearance, al-
though formidable in reality ; or from ^uds aXcafciv, i. e. warming
gently. And, as this fever is of the quotidian kind, being formed
by phlegm, it is to be treated in particular in the same manner ;
only that it requires remedies as much hotter and more incisive than
the quotidian, as its phlegm is colder than that of the other. The
rigor without heat stands in need of heating things still more than
the hepialus. Wherefore, the composition of thiee peppers, that
from calamint, and still more that from Cyrenaic juice are particu-
larly suitable to this complaint, as also the remedies prepared from
castor and the like. You will find a fuller account of these matters
in the 45th chapter, " on immoderate rigor and cold." The fevers
called Lipyrise, and the Typhoid or smoky, and whatever others arc
mentioned besides those described, being all of the same kind as the
above-mentioned, will require the same methods of cure as those
^bich have been mentioned, or will soon be described.
152 1»AULUS iEOINETA.
XXVII. — On the Continual Fevers,
The continual fevers are allied to each of the intermittents ; thus,
to the true tertian is allied the Causus or ardent fever ; to the quo-
tidian, that fever which has a paroxysm every day, hut does not
terminate in a complete freedom from fever ; and, in like manner,
to the quartan, that which has an exacerbation every fourth day.
For, the true causus has all the other characteristics of the tertian,
and differs from it only in not commencing with a rigor, nor ending
in a complete remission of the fever. The continual fever which
has an exacerbation every day, possesses all the other characteris-
tics of a quotidian, except that it does not terminate in a perfect
apyrexy. In like manner, the continual fever which has an exacer-
bation every fourth day, but does not terminate in a complete apy«
rexy, is allied to the quartan. A continual fever, therefore, is one
which does not terminate in any interval from fever until it is alto-
gether resolved. But when it evinces no remission, it is, indeed,
of the same class as the ardent fevers, but differs from them in
Hcutenesa.
XXVIII. — The Diagnosis and Cure of Synochous Fevers,
Synochous fevers are produced either by effervescence of the
blood, or putrefaction of the same, arising from obstruction, and
have, therefore, but one paroxysm from beginning to end. The
s3niiptoms are, pulse great, strong, quick, dense, equable ; but they
are not pungent ; and the urine is little different from the natural *
The cure of them consists in blood-letting ad deliquium. And those
who are affected with these fevers, and are not bled, run the most
imminent danger. But if any thing should prevent us from having
recourse to phlebotomy, we must use such other remedies as are
calculated to remove obstructions, those which evacuate, and such
as will allay the effervescence of the blood. But when in these
cases you remark symptoms of concoction of the humours, and
there is neither inflammation, sedematous swelling, nor scirrhus in
any important part, nor any part cold, so as that the evil may be
determined to it, you may boldly give cold water, more especially
if the patient has been accustomed to cold drink.
XXIX. — On the Diagnosis of Ardent Fevers,
The following symptoms accompany ardent fevers ; tongue dry,
rough, and black, griping of the stomach, excrements pale, strong
thirst, watchfulness, and sometimes delirium.
BOOK 8BCOND. 153
XXX.— The Cure of Ardent Fevers.
EiTHBR of the following things must take place, that this fever
may terminate completely ; the bilious humonrs most either be eva-
coated or extingaished. They are evacoated then by sweating,
vomiting, or purging downwards; but they are extinguished by
cold drink, with which we have entirely cured ardent fevers. For
diet, those in causns should not take water alone, nor mead alone,
but boiled mead much diluted with water ; for their food ought to
consist entirely of drinks. The bath will suit with those only af*
fected with causns who are free from all inflammatory and erysipe-
latous swelling. And if they exhibit symptoms of concoction, it
will suit still better with them ; but not so if the fever be occasioned
by a saltish humour. These should be supported with the juice of
ptisan.
XXXI . — Diagnosis and Cure of Fevers with an Erysipelatous
affection.
Fbvsrs accompanied with an erysipelatous aflection about the
viscera, may be known by the vehement effervescence and strong
pain in the part, also, by the thirst and inordinate burning ; in a
li^ord, by the S3anptoms of bitter bile putrefying along with a defi-
cient blood. They are to be treated in this manner : the patient
must abstain altogether from the bath, and at the acme of the com-
plaint, use the very coldest water. But it must not be used at the
commencement, but cold things are to be applied externally ; and
if this is not sufficient, they must be taken internally. Lettuces and
«uch like things are particularly befitting. The juice of the lettuce
is likewise a seasonable application externally, also, that of the
boose-leek (seny^er'^vivumj, and such like cooling things. We may
use the following application, which is an excellent one : Squeezing
out the juice of some cooling thing, we put it into a mortar with
purslain, then pound and strain it ; at the time of using, we mix
a little polenta with it, and place it in cold water to cool it. A
piece of cloth folded double is to be put into it, and afterwards ap-
plied to the hypochondrium, and not suffered to remain, but another
cold one must be substituted. We sometimes mix the oil of unripe
olives.
XXXII. — Diagnosis of Hectic Fevers.
The hectic fever is not only seated in the fluids and spirits, but
ftlso in the solid parts. It is unaccompanied with pain, and those
affected with this fever, imagine that they have no fever at all, for
they ars sensible of bo heat, all the parts being heated equally.
154 PAULUa a2:GIN£TA.
Hectic fevers have a double origin, for the most part supervening
upon ardent fevers which have been protracted so long as to con-
sume in time all the juices in the body of the heart ; or they may
come on while these still remain. The former constitute not only
hectic but marasmus. Those that come on while the juices of the
heart remain, seize upon the body of the heart, and hence the fe-
brile flame is kindled, like the flame of a lamp from its wick. This
is one of the modes of formation. The other mode is, when they
make their attack originally, commencing like ephemeral fevers,
from grief, anger, or much fatigue attended with heat. These may
be cured without difficulty ; but those of them which have termi-
nated in marasmus, it is impossible to cure. A hectic fever which
is running into marasmus may be easily recognised. You may see
the patients' eyes immeasurably hollow, turbid, dry, and aflected
with a certain squalid appearance. The vital bloom of their colour
is gone ; their forehead is parched and stretched ; they constantly
wink as if asleep, and yet the affection is not sleep, but an inability to
keep awake ; their temples are collapsed ; and what remains, but the
bones and skin alone? Tf you lay bare, and examine the parts about
the belly, you will fancy that none of the entrails and intestines re-
main, and that the hypochondrium is forcibly drawn upwards. The
skin is parched in the last extreme, the pulse slender, dense, and
hard. The heat on the first application of the hand seema faint,
but soon afterwards feels acrid and pungent. While, therefore, any
of the natural moisture remains, the fever is only hectic ; but when
the humidity runs the risk of being altogether consumed, a true
marasmus is formed.
XXXIII.— 7%e Cure of Hectic Fevers.
Thosb aflbcted with hectic fevers, should be well supplied with
food from the commencement, on account of the pungency of the
humours. The best nure is a moistening diet. You ought also
to give for nourishment, the juice of ptisan, and broths of chond-
rus, adding a little bread ; and to treat the patient with a draught
of moderately cold water, when neither inflammation nor putre-
faction of the humours is present. But if you conclude that the
lesion is great, you must proscribe the cold water, and have re-
course to the cold applications externally. To those aflfected in
this manner, baths are at all times proper.
XXXIV. — On Semi'tertians.
As a tertian paroxysm' commences with a rigor, and a quotidian
without one, the fever composed of both, brings on a degree of
shivering, which is less than a rigor, and greater than chUlness, as
being a combination of these two extremes. Whence, this fever
has not iminroperly got the name of semi-tertian. These fevers are
BOOK SECOND. 155
formed in two ways, either the two paroxysms aniting into one
period, or being mixed together from the commencement. When»
therefore, the tertian prevails, the fever is attended with a strong
shivering, and has even a certain degree of rigor at the attack.
Snch a fever also, soon becomes hotter and more ardent, and brings
on some vomiting of bile, or a discharge of it downwards, or a
sweat. When tiie other, the pituitoos, prevails, there is cold-
ness of the extremities, but little shivering ; neither are they ac-
companied with thirst, nor are they ardent. But when the ter-
tian intermittent and continual quotidian are equal in magnitude,
the commencement of the paroxysm is with shivering ; and when
that from phlegm prevails, there are contractions and shiverings ;
but, if the hotter species prevail, they soon acquire heat. This
is the true semi- tertian, being a fever formed from an equal com-
bination of both, a tertian intermittent, and a continual quotidian.
But that which is not the true semi-tertian, has either more of
the bilious, or of the pituitous character; which species is of
easiest cure, the smaller humour being readily overcome by the
prevalence of the greater, or by the aid of art. When the pitui-
tous state prevails, we must use the remedies mentioned for the
quotidian ; or, if yellow bile, those for the tertian, always bestow-
ing most attention upon that which is most urgent, but not neglect-
ing the other entirely.
XXXV. — On Epidemic Diseases.
Wb call those diseases Epidemic and Common, that attack many
together; which, having a common origin, have also a common
cause. Common diseases are produced by common food of a bad
quality, drinking of bad water, inordinate fatigue, the want of the
customary exercise, deprivation or repletion from the prevalence
either of a famine or of great abundance. The nature of the country
will also often occasion common diseases, either from its l3dng ad-
jacent to marshes, or to some deep pit, which emits a deleterious and
pCTnicious exhalation. These things happen frequently. But the
atmosphere which surrounds us may alter the temperaments, by
being hotter, colder, or more humid than ordinary. For, to other
causes we are not all exposed together, nor do we come in contact
with them for the whole day. But the ambient air is diffused
around all, and is inhaled by respiration. Now, the bodies of ani-
mals must undergo a change along with the differences of tempera-
ture. He, therefore, who is acquainted with these matters, will not
only be able to predict the diseases which are to arise from every
state of the atmosphere, but will be able also to prevent them by
substituting a counteracting regimen to the intemperament of the
air. Wherefore, those bodies which are disposed to a certain
disease, from a natural intemperament, will be affected by a similar
temperature of the surrounding air. But those of an opposite tem-
perament to the atmosphere, instead of being hurt, will be improved;
156 PAULUS iEGINBTA.
the excess of their intemperament being overcome by the opposite
excess. He that is acquainted with these things will preserve the
health, by substituting the contraries to the constitution of the body ;
sometimes perhaps using refrigerants, and sometimes heating things,
cooling with water, using restricted exercise and food, and plenty
of dilution ; and warming, by means of increased clothing, exercise;
more food, and less drink. And, by kindling a great pile, one may
change the air from a humid state to that which is dry and hot, as
they say was done by Acron of Agrigentum.
XXXVl. — On the Plague ^ from the Works of Ruffus.
In the plague there is every thing which is dreadful, and no-
thing of this kind is wanting as in other diseases. For there are
delirium, vomitings of bile, distension of the h3rpochondrium, pains,
much sweatings, cold of the extremities, bilious diarrhoeas, which
are thin and flatulent ; the urine watery, thin, bilious, black, having'
bad sediments, and the substances floating on it most unfavourable ;
tickling of blood from the nose, heat in the chest, tongue parched,
thirst, restlessness, insomnolency, strong convulsions, and many other
things which are unfavourable. Should a person foresee that the
plague is coming, by attending to the badness of the season, and the
unhealthy occupations of the inhabitants, and from observing other
animals perishing ; when one observes these things, let him also ob-
serve this — what is the character of the present season, and what
that of the whole year, for you will be able thereby to find out the
best regimen ; such, for example, as if the temperature of the season
ought to have been dry, but has become humid; in that case, it will
be necessary, by a drying diet, to consume the superabundant moisture.
Care also must be had of the belly, and when there is phlegm in the
stomach it must be evacuated by emetics. And when a fulness of
blood prevails, a vein should be opened. Purgings also by urine,
and otherwise by the whole body, are proper. But, if the patient is
afiected with ardent fever, and has a fiery heat about the breast, it
will not be improper to apply cold things to the breast, and to give
cold drink, but not in small quantity, for it will only make the flame
bum more ; but in full draughts, so as to extinguish it. But, if an
ardent fever prevails within, but the extremities are cold, and the
skin cold, the hypochondrium distended, and the stomach sends the
matters which have been melted, some upwards, and others down-
wards ; if watchfulness, delirium, and roughness of the tongue, are
present ; in these cases, calefacient remedies are wanted, to diflfuse
the heat all over the body, and every other means ought to be tried,
in order to determine the heat from the internal to the external
parts. The following propoma may be used ; — of aloes, two-parts,
of ammoniac perfume, two parts, of myrrh, one part ; pound these in
fragrant wine, and give every day to the quantity of half a cyathus
( 5v). I never knew a person, says Rufliis, who did not recover from
the plague after this draught. So says Rufitis. But Galen says
BOOK SECOND. 15/
concerning pestilential putrefactions, that to drink Armenian bole,
and, in like manner, the theriac from vipers, is of great service ; and
that, in the plague which prevailed in Rome, all died who were not
benefited by either of these things.
XXXVII, — On the Treatment of those who are seized tvith
Syncope from Crude Humours.
SoMB are seized with fever while having a great collection of
crude humours, and while the mouth of the stomach is disordered.
In them the hypochondrium is distended with flatulence, the orifice
of the stomach is more swelled than natural ; in some the complexion
is more turned white and watery, and in others black. None of
these can bear the loss of blood without the most imminent danger ;
but they require evacuation, although they cannot endure phleboto-
my or purging, for even without them they are disposed to fall into
a state of syncope. They are to be cured, then, by friction. It will
be proper, then, at the commencement of the disease, to begin with
rubbing the limbs from above, downwards, with moderately rough
linen cloths, and afterwards, the whole arms from above, downwards.
But when the limbs have been sufficiently warmed, and there ia
danger of a sense of lassitude, we must use a relaxing oil, but avoid
all astringents. When it is winter, we must also use a sudorific one,
such as the Sicyonian oil, or that of camomile. After rubbing the
limbs freely, we must next rub off the oil, and proceed to the spine,
which we must rub in like manner, and then return to the legs, and
from them to the arms again, and afterwards to the spine again, con-
tinuing this practice for a whole day. Honied water, in which hys-
sop has been boiled, is most beneficial in these cases. And they
must neither get solid food, nor soup, nor water, nor be permitted at
all to drink freely ; but they ought to be contented with honied wa-
ter alone for the first three days, and be rubbed in succession. If
the strength be moderately good, and the contents of the stomach do
not pass properly downwards, you may venture with a clyster. But
if there is a greater overflow of the superfluities than proper upon
the stomach, you must first boil the honied water well, for thus it
will be less laxative ; but when the belly is looser than proper, you
must not thus stop it, but, instead of the honied water, give the
juice of ptisan. But if the discharge still continue, we must support
with a gruel made from chondrus. But if we ascertain from the
pulse that the powers of the system are prostrated, it will be proper
to give bread out of diluted wine, provided there be no inflammation
of the stomach or liver. But should they be inflamed at the same
time that the body is loaded with crude humours, the state of the
patient is hopeless. If you perceive that the humours are thick, give
oxymel always instead of honied water ; or, if it is summer, the pa-
tient hot, and fond of cold drink, give him cold oxymel ; but when
in winter, it must be hot. Baths are most prejudicial to such per-
sons. If, when you are called, syncope has already come on, and
158 PAULUS JBQIN£TA.
the parts which I have mentioned are free from inflammation, give
a small bit of bread out of wine, and proceed straightway to the
friction in the manner I have described. In those cases in which
the syncope is occasioned by yellow bile infesting the mouth of the
stomach, we must give cold chink, and administer wine that is thin,
of a bright yellow colour, and old.
XXXVIII. — On t/wae who have /alien into Syncope from thin
Humours.
Those who have fallen into a state of syncope from thin humours,
must be treated quite oppositely to the manner described, for you
will find the diagnostic symptoms quite different. They must be
supported by taking a little food frequently. And their case is to
be thought hopeless when the liver or stomach is inflamed at the
same time that the powers are gone. In these afiections, the ex«
pression of the countenance speedily becomes death-like. It is ne-
cessary to support their strength with food, but their skin must be
condensed instead of being rarefied as in the former case. The air
must be cooled, and they must be rubbed with astringent oint-
ments. They must be furnished with food not very laxative, also
bread and g^els from chondrus, with autumnal fruits that are
austere, and not apt to spoil ; these, either by themselves or with
bread. A watery wine taken from the beginning with the food will
be beneficial.
XXXIX. — On the other causes which occasion Syncope.
Thkrk are four other causes from which men fall into syncope ;
namely, violent pain, watchfulness, too great evacuation, and some-
times motion when in a state of delirium. To these, if you please,
you may add a fifth, namely, an intemperament of the primary or-
gans. Death takes place most quickly when the heart is aflfected,
next, when the brain, but not so when the liver.
XL. — On Pain.
A TORPID pain is occasioned by a cold aflection ; the pulsatory is
characteristic of a strong inflammation. But, if a jierson feel as if
pierced by a sharp-pointed instrument, or bored by a wimble, this
kind of pain is from the thick intestine, i. e, the colon. The pungent
is seated in the membranes. The darting pain attends the most ve-
hement attacks, not only of hemicrania, but also of cephalsea. It
is said to be darting when commencing in the seat of the affection,
as from a root, it spreads quickly to the surrounding parts. Dis-
tending pains take place in the nerves, when they are aflected and
stretched towards both extremities, but they are not liable to be
BOOK SECOND. 169
afS&cted with lateral distensions. The membrane under the skin
when distended occasions tensive and torpid pains ; those between
the flesh, as it were, divellent. For they are many, have irregular
insertions, and surround the flesh. But the pains proceeding from
the membranes which surround the bone, are deep-seated, and seem
to proceed from the bones themselves. Wherefore, when no external
caase of the pain is apparent, you must consider the patient's preced-
ing regimen. If it has been more inactive than usual, or if he has
been taking more nutritive food than common, or if any evacuation has
been suppressed, — if any or all of these circumstances be observed,
plethora is the cause of the pain, and you must evacuate him as
quickly as possible ; for, by this means, you will be enabled with all
safety to use such remedies as are fitted to repel the defluxions from
the aflSscted parts. If the part be distended with a fullness of blood,
open a large vein near it immediately ; but when crudities alone
are the cause, you must purge ; and, when both meet together, you
mast use both evacuations, beginning with the bleeding. If, after
both these remedies have been tried, the pain continue, it is clear
that the ofiending matter has become fixed in the part afiected ; and
it is also clear, that the cure will be accomplished by discutient reme-
dies. In like manner, we may cure pains from flatulence, by sooth-
ing them with attenuant food and injections, and opening the pores
of the part with cataplasms, irrigations, and fomentations. If a
swelling bearing down and pressing upon the part be the cause of
the pain, it must be removed ; but, if it proceed from a pungent
humour, attenuant and calefacient things are most improper. Dill
boiled in oil is anodyne and soporific, and the green more than
the drv.
XLI. — On CoUiquaiive Diarrhoea or Melting.
Whkn any thing is discharged from the bowels which was not
part of the food or drink that was taken, but of the fluids of the body
which had flowed to them, (resembling the yellow bile which is con>
tinually discharged by vomiting and purging, but differing from it
infoetor ; and in this, that the alvine discharge is of a darker yellow,
of the consistence of the sordes balneorum, oily, and adipose) the
disease is called colliquation or melting. At first, the fat and newly-
made flesh are dissolved and melted by the heat of the fever, but
as the evil is protracted, the solid parts themselves are melted down.
In this most unfavourable state of fever, a draught of cold water from
the coolest fountain is the most proper remedy. Likewise, cold
cataplasms and epithems ought to be applied to the chest and hypo-
chondriac regions, and cooling food g^ven.
XLII. — On Watchfulness in Fevers.
Tbosk who are much troubled with insomnolency, we are to
160 * PAULUS ifiQINETA.
direct to have their legs and hands bound with ligatures at the time
when they were accustomed to go to rest ; and make them keep
their eyelids open, or wink, until they are sufficiently fatigued ;
then we suddenly loosen the ligatures, remove the lamp, and order
complete stillness to be preserved. But, when the insomnolency is
obstinate, we must bathe the forehead during the decline of the pa-
roxysm, with the decoction of the heads of the black poppy, and direct
the patient to snuff up the dried and powdered husk of the white
poppy ; or from the root of the mandragora pounded with wine, or
rose oil, we make an emollient ointment (malagma), and rub the
forehead with it. Or, we use, during the paroxyms, wild thyme
boiled in must with melilot. Or, taking the pounded heads of
poppies, we make a cataplasm of it with bread and rose oil, or ce-
rate. And the greatest attention ought to be paid to the food. Let
about three spoonfuls of the seeds of the wlute poppy be added to
the patient's gruels ; and let his pot-herbs be prepared by adding
to them as many of the leaves of the black poppy, if green, as can
be contained within three fingers ; or, otherwise, three or four
dried heads may be boiled with them and taken. If, even by these
means, sleep cannot be procured, let him be smeared with the juice
of poppy or of mandragora. But the electuary composed from the
heads of poppies, and, particularly that which is drunk with sodden
wine, to the amount of a spoonful, or a spoonful and a half, disposes
to sleep. Those who are not troubled with fullness of the head
may use the following fumigations in the decline : — Of Indian Leaf,
of amomum, of costus, of amabo, of each oz. 1, of the fruit of the
balsam tree 9>. 1, of storax, of ammoniac perfume, of Scythian
bdellium, of the root of the mandragora, and juice of poppy, as
much ; use as a fumigation with C3rpress-wood.
XLIII. — On Cataphora or Somnolency.
Spongb the forehead with oxycrate of the temperature of new
milk ; put tight ligatures round the extremities ; and apply to the
nose strong- smelling things of an incisive quality. In the remis-
sions, apply cupping-instruments between the shoulders along the
spine. Wlien the disease is protracted, errhines must be tried dur-
ing the decline. Let the food consist of such things as have in*
cisive and dividing properties, as recommended by us in our general
directions regarding the health.
XLlV.— On the Cure of Headach in Fevers
When headach proves troublesome in fevers, after the accustomed
evacuations, in the decline of the paroxyms, the head ought to be
anointed, first with the common oil from unripe olives, or with rose
oil, to which some vinegar has been added; which, if it be the sum-
mer season, and the fever of the ardent type, may be used cold ;
BOOK SECOND. Itil
bat, in winter, if the fever be not ardent, it mast be hot or tepid.
In the oil, may be boiled the juice of wild thyme and knot-grass
(pofyffonum) I and in summer, the heads of the poppy, or the
poppy itself may be added, as in winter, a little of the hogs-fennel
may be sabstituted in place of it. When the pain continues in the
forehead, if the open of the head be bare, a poultice may be ap-
plied to it, made oif old barley-meal and knot-grass ; or, in like
ttianner, of bread and roses, or of some myrtle or wild thyme.
Some are rather benefited by an admixture of penny- royal, and
otherA, when the affection was of a hot nature, have rather been
reoiedied, by having flea-wort (psyllium) added to the barley-
floor, or even by this sdbitance alone, when boiled to the con-
ttStenc^ of bird-lime. It mnst be frequently changed. Coriander
with barley-meal may be used in like manner. Aloes with myrrh
are also to be rubbed in, or myrrh and ammoniac in like manner,
and crocomagma. Pulsatory pains are dispelled by rue and mint,
with bread, to which a little rose oil has been added. When* the
paiti does not yield to the afore-mentioned remedies, we must first
cut the hair close by the skin, and then rub some of the oily em-
brocations over it all ; after which, cupping- instruments are to be
applied to the hind-head, and the extremities to be bound with
l^^tares, and chafed. Leeches also are a proper application. But
if a catarrh or defluxion raise the pain in the' head, we must ap-
ply the remedies which will afterwards be described in the pro-
per place. But if exhalations from the stomach have been carried
upwards, and hurt the head, we must attend to them, as will be
mentioned below.
XLV. — On the Care of Stomach Affections,
If the stomach be weak, we must apply strengthening cataplasms
to it, such as those made of dates and wine, and of polenta and
saffiron, and of mastich and aloes ; and use embrocations from worm-
woody the oil of apples, and of mastich, nard, and wine ; and if hot,
we must add cooling things, such as the juices of gourd, lettuce,
ptorslain, night-shade, endive, and unripe grapes. But if the
bowels appear to be inflamed, it will be proper to add to the embro-
cations some of the relaxing medicines, such as oil of camomile
and of privet, the grease of a cock or goose and bdellium, ammo-
niac, or the like ; and to the cataplasms, the seed of parsley and
fenugreek, the flowers of the marshmallows and camomile ; and, in a
word, let the application be a compound of relaxing, attenuant, bit-
ter, and astringent properties.
XLVI. — On Inordinate Chills and Rigors in Fevers.
Whsn rigors are critical, we must not interfere with them, nor
attempt to put an end to the struggle ; and a chill succeeding to a
162 PAULUS .EGINETA.
sweat will readily pass away and give no trouble. But when the
rigor and chills are protracted, and more particularly, if occasioned
by a collection of cold phlegm, we are first to apply ligatures round
the limbs in various ways, and then anoint them with the oil of
camomile, or of privet, or of iris ; or, if a stronger application be
required, we may add to the oil some pepper, or the seed of the
rosemary, or adarce, or castor, and the whole body is to be gently
rubbed with these things. And in order that the oil may not run
off, a small quantity of wax may be melted with it. Or, if it is the
rigor not attended with heat, we must use the most powerful re-
storative ointments (acopa), and also, dropaces and sinapisms.
Proper fomentations ought likewise to be got ready. The acrid-
scented things are likewise proper, such as calamint, penny-rojral,
and hyssop. Before the attack, we should likewise give for drink,
honied water, in which pepper and rue have been boiled. And wis
should likewise give of the Cyrenaic juice, to the size of a millet,
two hours before the paroxysm, mixing it up with boiled honey ;
and we are to give the juice of the laser- wort in like manner. And
the composition for quartans, made from the Cyrenaic juice, has
proved beneficial to many. And some, by going into a bath of hot
oil, have shaken off obstinate rigors, as Archigenes affirms. But
Galen directs before the attack, to rub the skin with southernwood,
or dried calamint, or the leaves and flowers of flea-bane (conyza),
or with costus, or pellitory, these two last with oil. By these
means, the rigors will nearly or altogether cease.
XLVIL— 0?i Sweats,
Wb must allow critical sweats to go on until they produce the
necessary evacuation, and co-operate by means of moderate heat
and rest, and not wiping away the sweat (for one brings on ano-
ther), by washing the mouth with warm liquids, by warm drinks,
and by sleep. The sweats which occur in the decline of a fever,
are to be treated like the critical. Sudorific remedies are suffi-
ciently treated of in the 48th Chapter of the First Book. But
when the sweats exceed in quantity, they must be wiped oflf, and
the covering of clothes lightened, so as to cool the patient. For,
by exceeding, they occasion lassitude, and often bring on syncope.^
Let, therefore, the covering be light and moistened ; let the air bie,
cooled; and let ventilation be used during sleep. Let the black
myrtle, pounded, be sprinkled on the body, and gall, and the bark of
the pine in like manner. Let amber and polenta, with astringent
wine, be applied to the proper parts ; and let the face be sponged
with oxycrate. Archigenes uses asbestus and the burned lees of
wine in these cases, and for the rigor not succeeded by heat. For
both, he says, when heated, become dry. He also directs to bathe
the middle parts of the body with the juice of plantain, or corian-
der, or purslain, or cabbage, that they may obstruct the passages of
the sweat. In sleep, pieces of cloth smeared with Cimolian earth
BOOK SECOND. 163
«
diisolved in water, are to be applied to the back and chest. And
the whole body should be anointed with the oil of roses, or of ap-
ples, or of lentisk, or of myrtle, or with the cerates ft-om them.
Bat fatty substances are particularly adapted to them ; for, by shut-
ting up the insensible pores, they prevent the passage of the fluid.
It is clear, that dry food and moderately astringent wines are befit-
ting to them ; but much drink should be avoided, and, in particu-
lar, all things of a very liquid nature, and likewise ft-equent wash-
mgs of the mouth. But, if possible, gestation should be taken in a
cold state of the air. The extremities in particular, are to be cooled by
these means. For those sweats which are extorted by spasms and
pains, tight ligatures, or fomentations, are to be applied to the ex-
tremities, and they may be relieved by gently rubbing with woollen
cloths.
XLVIII. — On Cough in Fevers,
Wx must endeavour to remove a cough in fevers, more especially
in such as come on with rigors, for it exasperates the fever when it
is subsiding. We must give lozenges from boiled honey to hold
below the tongue, for these melt and remove the substances which
obstruct respiration. The time for using them is at the acme of the
paroxysm, and a short time before the attack. Well-boiled hydro-
mel must likewise be given. When there is no suspicion of the
nerves being affected, in process of time you may give oxymel with
confidence, or if not it, the decoction of hyssop, which is a remedy
also for rigors. If the fever is not of the ardent kind, you may
give castor, which is also of use to the nervous system. Electua-
ries may be used, made of the kernels of the common and wild pine,
ins, liniseed, bitter almonds, and nettle-seed. But the most of these
niay be mixed with the food. Turpentine-rosin should be given in
an egg. To the chest and the parts about the trachea, apply a sul-
phurated woollen cloth, and oil of rue, or of iris, or of dill. Tight
ligatures long applied, are excellent for stopping cough, I mean to
the middle and extremities. Nor will it be unsuitable to use staves-
acre dried, which may be chewed with dried grapes or mastich.
The extremities may be rubbed, chafed, and bound with ligatures,
and afterwards the retracted parts unbound. But if the cough an-
noys, owing to the acrid nature of the fever, we must use a gargle
of tepid water. Cold water also is often useful ; and, in like man-
ner, gargles of oxycrate, or of the decoctions of dates, roses, or li-
^Qorice. Moderately cooling things are also to be laid over the
Wels and heart.
XLIX. — On Sneezing.
- Bnxbzing frequently occurring in fevers is troublesome, for it
^ I ^^termines to the head and weakens the strength, and, in some
m2
164 PAULUS iEGINETA.
cases, it produces a discharge of blood. Such are the bad effects
of sneezing, which ought, therefore, to be contended against. It is
restrained by rubbing the nose, forehead, and eyes ; by yawning, fre-
quent friction of the roof of the mouth, eructation, stretching of the
loins, raising the head, turning to the side, gently chafing the ex-
tremities, anointing the masseter muscles, pouring hot oil into the
ears, applying a warm cushion under the chin. It is proper to
avoid being roused suddenly from sleep, and also smoke, dust,
acrid smells, pepper, castor, mustard, and mint. The smell of ap-
ples and polenta is proper, for it blunts the desire of sneezing.
The empty sea- sponges do the same. When there is a ft-equent de-
sire of sneezing without the ability, let the lips be composed, smell
to acrid substances, and let the mind be relaxed.
L. — On Loss of Appetite.
When loss of appetite is occasioned by depraved humours, we
must give those kinds of food and drink, which will either clear
away such humours by vomiting, or downwards by the belly, or
those that by dilution will render them better. You have the ma-
terials of these things treated of in the First Book of this work.
Should the loss of appetite be occasioned by debility, since all debi-
lity is owing to an intemperament of the parts, we must cure the
species of intemperament by its contraries. Wherefore, we will
give a more particular account of loss of appetite in treating of
stomach complaints in the Third Book. But, in fevers, we must
straightway endeavour to bring back the appetite with aromatics,
more particularly by giving polenta pounded in water, or ozycrate,
or diluted wine, or a decoction of some of the fragrant and astrin-
gent ft'uits ; by gentle unction and moderate friction of the whole
body, by chafing, by bathing the face, and swallowing a small
quantity of water. And, by putting the fingers down tibe throat,
the stomach has been roused to bring up the food, more especially
if the fluid discharged be bilious or acid. After the fir&t days, cata-
plasms of dates, of apples, of the wild vine, of wormwood, and of
aloes, ought to be applied over the stomach. Let a variety of sim-
ple food be prepared, and from grain, having some difference from
the common articles, but not very different from those used in fe-
vers ; and among them, those fruits which do not readily turn acid,
nor are very sweet, but are ripe; however, they are not to be eaten
to satiety, but only so as to whet the appetite for other food.
While they are eating, the most delicious articles ought to be pre-
sent, which may have the power to provoke and incite the desire.
After the fever is gone, should the want of appetite continue during*
the recovery, yellow parsnip boiled with oxymel, and lettuces, and.
pickled olives, and capers, and pickles, the bulbi, and every other
stomachic should be thought of; and, in particular, those things
should be recollected in which the patient delighted most when ixx
good health. Walking, gestation, vociferation, calefkcient plasters*
BOOK SECOND. 165
frictions, and exercises, ought to be had recourse to. And drinking
the propoma from wormwood, or from aloes, or swallowing the
vinegar of squills to the amount of a mystrum, have proved excellent
remedies.
LL — On Bulimos or Inordinate Hunger.
If want of appetite should pass into the opposite state, I mean
an excessive atrophy, called bulimos, we must resuscitate such per-
sons with roasted pork, or kids, and other savoury things ; and, in
a word, we must use every strong-scented thing, if the acute stage
of the fever be past. We must bind the extremities, and rouse,
by pinching the cheeks, and pulling the hair and ears. When
recovered, we must give bread that has been dipped in diluted
wine, or any other diffusible thing.
LII. — On the Canine Appetite.
Although this symptom seldom occurs during fevers, it some-
times does afterwards ; and, as it is allied to loss of appetite, as
being the opposite extreme, it will not be improper to treat of in-
ordinate appetite. Since, therefore, this affection is generally oo
casioned by an acid phlegm, we must use those things which will
divide aftd dissipate it. Such, in particular, are all sweet and saline
things, and those which are called heating detergents. We must,
therefore, give largely of the heating wines. Such are the gold-
coloured, and those which are red without being styptic. We must
also give them the sweeter kind, although tiiey should not be
thirsty. When they come to dinner, we must give them first, all
&tty things, and evfery thing beside which is prepared with much
oil, and has no austere or astringent property. These, although
(hey should not overcome the cause of the complaint, at all events,
destroy the insatiable desire of food; but abstinence from them
lessens the collection of phlegm in the stomach. We must also
give pickles, and after them, plenty of the afore-mentioned wines
to be drank. By x>ersevering with these things for some time, the
complaint subsides.
LIIL— 0» Thirst.
A protracted thirst may be supposed to be occasioned by dryness,
or heat of the parts by which liquids pass from the mouth to the
stoinach ; and the natural cure of dryness is sleep, and» of heat,
watching. Some become thirsty from wine, or the heating nature
of their food, in which case, the proper cure is cold drii^. But
some desire drink of a bad quality, as they do food corresponding
to the prevailing cacochymy. I have known persons seized with
166 PAUL.U8 JEGISETA.
unquenchable thirst, of which they died, who had eaten of the
vipers called dipsades, and others who had got drunk upon old
wine ; and also persons on board of a ship, who, when their fresh
water failed them, had drank of sea water, have all died. Febrile
thirst may be mitigated, by pouring upon the head the coldest oil,
or rose oil. But the best remedy for thirst, is the seed of the
black lettuce, chewed, or the liquorice ; or, seed of the cucumber
may be retained in the mouth. Give also the following pill, called
adipson : — of gaVden cucumber, dr. viii. — of tragacanth, dr. iv. —
dissolve the tragacanth in the white of fresh eggs, and when dis-
solved, add to the pounded seeds of the cucumber; and when
softened, form pills, which dry in the shade. Give one of these
pills to hold below the tongue, and drink the fluid of it as it dis-
solves. Give also, to swallow, the decoction of quinces, or of pears,
or of medlars, or of the tendrils of the vine, or the juice of the po-
megranate.
LIV. — On Roughness of the Tongue,
Wk may moisten asperity of the tongue, by making the patients
retain in the mouth a decoction of linseed. But it will be more
efficacious, if sebesten plums be boiled with the Unseed. Having
immersed the finger in this liquor, and rubbed the tongue with it,
let them rinse the mouth with clear water, or let them clean it
with a sponge, and then anoint it with rose oil. And the oil of
roses mixed with honey also answers well. Likewise the juice of
the purslain retained in the mouth, and the sumach used for condi-
ments, when mixed with honied water, have a good effect.
Damascenes, also, and the bones of the sebesten plum retained in
the mouth, and rolled on the tongue, and the stem of the lettuce,
answer well. Archigenes says, that the Indian salt, which, in
colour and consistence, is like the common salt, but which re-
sembles honey in taste, when chewed to the size of a lentil, or, at
most, of a bean, does moisten greatly. They should lie upon the
side (for lying upon the back dries greatly), and they ought to
keep the mouth shut, because keeping it open allows the moisture
to dry up. Sneezing properly produced, moistens the tongue xaore
effectually than any other means.
LV. — On Nausea.
Whbn nausea comes on without being produced artificially, it is
a clear inference that noxious humours are vexing the stomach.
Some feel uneasy, but vomit nothing, the humour being retained
in the coats. When the humours are pituitous, we must g^t them
concocted by rest, spare diet, and sleep. But the thinner may be
ejected by vomiting, produced either with the juice of ptisan, or
with honied water. But those which are viscid and thick, stand in.
BOOK SECOND. 1(>7
need of attcnuant remedies, such as oxymel, and the like. But,
when a noxious fluid is detained in the coats, the powder from aloes,
called Picra, is heneficial, hut astringents are pernicious ; whereas,
if there be much fluid, but not of a noxious kind, astringents will
be beneficial, but the aloetic medicine will bring on marasmus.
When cold is joined to humidity, we must mix calefacients with
astringents. The symptom of the affection being of a cold nature,
is, that there is no thirst, nor sensation of heat.
LVI. — On vomiting of Bile,
To those who vomit bile, a cataplasm must be applied, made of
dates, the rind of pomegranate, and gall, boiled in wine or oxy-
crate, along with pounded bread. And acacia, hypocystis, and the
flowers of the wild pomegranate and sumach, ought to be added to
it. A cupping-instrument, also, when applied with a strong heat, is
of great service. Food ought to be given frequently in small quan-
tities. To those who vomit black bile and have the stomach in-
flated, apply sponges soaked in hot vinegar of the most acrid quali-
ties, or a cataplasm of the leaves of the ivy boiled in wine.
LVII. — On Hiccough.
Singultus is occasioned either by fulness, or emptiness, or the
presence of acrid and pungent humours in the stomach, and when
they are vomited, it ceases. And many, if they only take the medi-
cine composed of the three kinds of pepper, and drink wine imme-
diately after, have hiccough. And it is well known, that many
people hickup when the food spoils on the stomach. Many also
hickup horn, rigors. We will find an emetic a proper remedy in cases
which are occasioned by fulness or pungency, and warmth in those
from cold ; and, when the complamt is occasioned by a plethora of
humours, there is need of strong evacuation. This may be accom-
plished by sneezing, but when emptiness is the cause, sneezing will
not core it ; for in such cases, we must give rue with wine, or nitre
in honied water, orhartwort, or carrot, or cumin, or ginger, or cala-
minty or Celtic nard. These are the remedies for such cases as are
occasioned by corruption of the food, cold, or plethora. When a
redundance of cold and viscid humours is the cause, give castor to
the amount of three oboli to drink in oxycrate, and the same thing
will be of use when applied externally to the skin, along with old
Sicyonian oil. The vinegar of squills or oxymel may also be drank
with advantage. Retaining the breath is likewise of great use.
168 PAUMTS iCGINETA.
LVIII. — On Constipation and Looseness of the Bowels in
Fevers.
Those things which remedy a dry state of the bowels are treated
of in the First Book sufficiently. But since a humid or loose state
of the bowels may prevail in fevers, this also must be treated of ;
for many are cut off not by the fever itself, but by this symptom
alone. In the commencement, we must not interfere with the dis-
charge when it proceeds from corruption of the food and indiges-
tion ; but when the evacuation becomes immoderate, it must be re-
strained. If the discharges are of an acrid nature, that which is
given should consist of good juices, and be otherwise thick, such as
spoon-meats from pearl-spelt (chondrus,) and ptisan. Baths are also
befitting after the complaint has become concocted. But when the
discharges consist of phlegm and are watery* on the other hand,
the food ought to be of a more dry and heating nature, as far as the
fever will permit. Of this kind, are those things which are prepared
from heating condiments. But they must abstain horn baths, un-
less otherwise required. When the digestive faculty is in an atonic
state, we must give food and applications of an astringent nature ;
the food consisting of things in particular, to which pomegranates,
apples, pears, or medlars, have been added, or these fruits them-
selves, and thin fragrant wine of an astringent quality ; and the
applications are to be cataplasms made of polenta, and dates, and
wormwood, roses, myrtles, and such like things. It most be con-
sidered also, to what part these cataplasms are to be applied, I mean
the region of the stomach, the lower belly, or perhaps the loins.
Bloody discharges are restrained and dried up by remedies contain-
ing fine flour of polenta, with frankincense, or manna mixed wttb
wine, or oxy crate. When the watery discharge is acrid, it most
be sweetened by a lavement either with water alone, or the juicQ
of ptisan, or of chondrus, or rice, or tragum, not once, but often;
and afterwards there are to be added dried roses, or myrtleau aa4
sometimes galls ; and an egg with rose oil, and a thin astringent
wine, or the decoction of roses, may be injected or applied to tbsir
anus, which will blunt the desire of going to stooU . But when the
calls are frequent, a clew formed of warm threads may be applied tc^
the anus.
LIX. — On Trickling of Blood and Hemorrhage from tAs Nose.
Since a trickling of blood indicates a fulness in the whole body,
or in the head, being occasioned either by expression or conden-
;^tion, and as a free evacuation would relax them, and diminish
the quantity, it may be proper to evacuate where nature points.
With this view, I have ventured, in cases of quartan epistaxis,
to open the vessels in the nostrils with the reed called Typha.
We must not be contented with a small evacuation, but must take
BOOK SECOND. 169
away blood in proportion to the strength. Spontaneous hemorrhage
from the nose in fevers, when critical, are not to be interfered wiSi ;
but yet, if the flow of blood be immoderate, it ought to be restrained.
In the iirst place, tight ligatures ought to be applied to the patient's
extremities, and his head elevated. It would appear that a ligature
to the privy parts, is particularly adapted for restraining bleeding
from the nose. The nostrils ought not to be wiped, nor the part
irritated, so that a clot of blood may be allowed to form. Let the
nose be cooled by a sponge soaked in oxycrate, and the nostril
plugged vLp with a pledget dipped in some of the astringent appli-
cations. The composition of them, and the rest of the treatment,
we will deliver more fully in the following Book, " on the parts which
are afiected."
LX. — On Deliguium Animi or Swooning.
« Whbn the fainting is occasioned by cholera, diarrhoea, or other
repeated and copious evacuations, we must sprinkle water upon the
patient, twist his nose, rub over the orifice of the stomach, and en-
courage vomiting. We should also irritate the sesophagus with our
:fingers or a feather. Several strong ligatures are likewise to be ap-
plied> when the evacuations are downwards, to the arms ; and,
when upwards, to the legs. The patients are also to be placed in an
easy erect posture, and a cupping-instruxnent applied, so as to pro-
duce revulsion to the opposite part of the body. Wine and water
relieves prostration of strength occasioned by ft-equent evacuatio|is,
provided there be no inflammation of any visceral part, nor violent
headach, nor delirium* nor ardent fever unconcocted, to contra-in-
dicaJte it; for in suc^ casesi wine will do much mischief. And, if it
be summer, and the patient of a hot temperament, and addicted to
drink cold things^ we may give cold drink ; but if the contrary,
warm. When the deliquium is occasioned by profusion of sweats,
we are to constrict the skin, as formerly said, and allow a free current
of cool air. In defluxions on the stomach, none of these things is
fitting, unless the application of strengthening things to the belly
and stomach, and bathing them ; for baths are most beneficial in
cases of stomach defluxions, but greatly aggravate hemorrhages and
sweatings. Those who have fainting fits from plethora, must abstain
from wine, and food, and from baths too, if there be fever. And we
must give them honied water, having thjnne^ marjoram, penny-
royal, or hyssop boiled in it. Oxymel also is beneficial to them.
But if the faintings proceed from depraved humours contained in
the stomach, we must diiect a vomit with water and oil — at the
same time tickling the throat with the finger or a feather. But if
vomiting cannot be thereby procured, we must give pure oil, which
will often evacuate downwards. And wormwood is applicable in
such cases. But if the faintings are occasioned by weakness of the
stomach, we must use tonic medicines, as formerly stated in the
chapter which treats of this aflection, and rub the extremities.
'70 PAULUS itlGINETA.
When they proceed from exposure to immoderate heat, we are to
prescribe the bath ; or, when from excessive cold, we must use the
medicine containing the three peppers, and pepper itself. Those who
fall into fainting fits owing to great heat, or insolation, or from re-
maining long in the bath, may be cured by being sprinkled with
cold water, and exposed to the wind ; by having their stomach rub-
bed, and getting wine and food. But if the swooning be occasioned
by the greatness of the inflammation, or bad nature of the fever in
the attacks, and if the patient is cold, we ought to rub his limbs
strongly, chafe him, apply ligatures, force him to keep awake, and
abstain from food. And these things are to be done previous to the
paroxysm. But those who have fain tings from dryness, two or three
hours before the paroxysm should get for food either the juice of
chondrus, or bread out of water, along with the kernels of the
pomegranate, or apples, or pears. But if great danger be antici-
pated, we must also give wine. Those who have sudden attacks of
fainting are to be thus treated. And in all cases we are to find out
the cause of the deliquiom, and direct our attention to it. And
sometimes the greatest care must be bestowed upon this symptom,
which threatens danger, or death itself.
LXI. — On Ulceration about the Os Sacrum.
This affection occurs most frequently in protracted fevers, owing
to the patients having been long confined to bed. When, therefore,
the part begins to appear red, we make a circular piece of wool,
of the proper magnitude, and lay it below the part, and afterwards
prepare a rose or m}n-tle cerate, containing litharge or ceruse, and
apply it. When there is inflammation, we may use a cataplasm of
bread, with nightshade, or knot-grass, or plaintain, or tender cab-
bage. But if the ulceration be spreading, we are to use a cataplasm
of dried lentils, along with the inner rind of the pomegranate.
COMMENTARY
OK Tax
SECOND BOOK
or
PAULUS iEGINETA.
Ji BE following ancient authorities may be consulted on the subject of
^erer; — Hippocrates, Epidem, et alibi. — Galenus, Comment, in Hippocr,
JEpideniy de Differentiis Fehrium, Meth, Med, lib. viii. Therap, ad Glauc.
lib. i. De Typis, de Criiibus et alibi, — Celsus, lib. iii. — Pseudo-Dioscorides,
jEiuporiit, lib. ii. — Oribasius, Synop. lib. vi. Euporiit. — ^Areteus, Morh,
.Jkcut, ii. 4. — ^Aetius, lib. v. — C. Aurelianus, Fau, Acut, ii. 10. — ^Alexander,
lib. xii. — Alexander Aphrodisieus, Probl.i, 84. — ^Actuarius, Meth. Med. lib.
iii. — Plinius, H. N, xxriii. 66. xxx. 30. — Palladius, de Febribus. — Psellus,
€)ptu Medicum, — Synesius, de Pe6rt6tis.— -Constantinus Africanus, de Febri'
ims, — Serenus Samonicus. — Vindiciani Epistola ap. Fabricii Bibl, Grmc.
torn. xiii. — ^Avicenna, lib. iv. fen .i. — Syrasis Avicenna Expositor, — Haly
Abbas, 'Fheor. viii., Pract, viii. — ^Alsaharavius, Theor. vi., Pract, xxxii. —
Serapion, tr. vi. — Avenzoar, lib. iii. tr. 7. — Averrhoes, Colliget. lib. vii.—
Ilhases, ad Mans, lib. x., ContinenSf lib. xxx.
I. PREFACE TO THE BOOK ON FEVERS.
All the ancient authorities held, that a Fever consists of a preternatural
increase of the innate, or, as it is now called, animal heat. Thus, Palladius
defines a Fever to be ^* a preternatural heat, which begins in the heart, and
is diffused by the arteries over the whole body, sensibly injuring the actions
of the body.'' Hippocrates, Galen, Aetius, Alexander, Psellus, and Actua-
rius, give similar dennitions. Cslius Aureliauus, says of Asclepiades : — ** Fe-
brium ponit signum calorem plurimum.^* — Morb, Acut, i, 14. Isidorus defines
a Fever thus : — ** Febris a fervore dicta est ; est enim abundantia caloris/'
Orig. The celebrated Erasistratus maintained an opinion, lately revived by
Clutterbuck, that Fevers and Inflammations are identical. — (See Milligan s
Celsns, p. 13. and p. 112). He further taught, that in Fevers, the blood of
the veins is thrown into the arteries. Plutarch, de placit, Philos, v. 29.
172 COMMENTARY ON THE SECOND BOOK.
The Arabians adopt the opiDions of Hippocrates and Galen. Thus,
for example, Haly Abbas defines Fever to be a preternatural heat proceed-
ing from the heart, and diffused by the arteries over all parts of the body.
According to him there are three kinds of Fevers. First, those which are
seated in the spirits, and affect only the heat of the body. These are called
£pheraeral Fevers. The Second, originate in a vitiated state of the fluids,
which impart a preternatural degree of heat to the heart, whence it is dif-
fused over all the body. The Third arise in the vital organs and solid parts,
from which heat is transmitted to the heart. Pract, viii 2. — See also, in
particular, Rhases, Cont. lib. Xxx.
That an increase of the temperature of the body is an almpst invariable
concomitant of Fever, was satisfactorily proved by the,thermometrical ex-
periments of Dr. Currie. Medical Reports.
II. OF THE PRINCIPAL CONSIDERATIONS TO BE INQUIRED INTO WITH
REGARD TO FEVERS.
This Chapter, and great part of the Contents of this Book^ are taken from
Galen, Therap, ad Glauc, lib. i. or from Oribasius, Synop$, lib. vi.
III. WHAT TO CALL THE COMMENCEMENT OF THE DISEASE.
The whole of this Chapter is taken from Galen, de dUhus discretoriis,
where the question is fully discussed. Aetius, like our author, defines the
commencement of a Fever, to be the time when the strength of the patient
being overcome by the complaint, he is obliged to take to bed. On this
point, the Arabians venture to differ from the Greeks. Thus, Rhases and
Avicenna reckon the commencement from the time when the patient first
feels a departure from health.
The disagreement among the authorities upon this point is to be regretted,
as it tends to obscure the doctrine of the Critical Days.
IV. HOW TO KNOW WHETHER THE DISEASE WILL PROVE FATAL
OR NOT.
This description of the fatal symptoms of common Fever, will bear a com-
parison even with Pringle*s admirable detail of the unfavourable appearances
of Jail Fever. Our author's description, indeed, is mostly taken from the
Prognostics of Hippocrates, and the Commentary of Galen upon the same.
Galen gives an explanation of the causes of the symptoms, from which we
shall select a few specimens. It is one of the Prognostics of Hippocrates,
that profuse perspiration in acute Fevers is unfavourable; and, in explana-
tion of this, Galen states, that a critical sweat may indeed be favourable ;
but that such as are profuse and continued, indicate a complete prostration
of the vital powers. A fixedness of the eyes, is said, by Hippocrates, to be
a fatal symptom ; the reason of which, according to Galen, is, that it pro-
ceeds from paralysis, or insensibility of the muscles of the eye. Hippo-
crates mentions it as an unfavourable symptom when the patient lies with
bis mouth open; and Galen, with seeming propriety, attributes this symptom
to the origin of the nerves, that is to say, the brain, undergoing pressure.
Hippocrates states, that involuntary discharges from the bowels are an un-
fevourable symptom; and Galen justly remarks, that they indicate' great
insensibility.
COMMBNTART OK THE SECOND BOOK. 173
Celsus fi^ves an elegant translation of this part of the works of Hippo-
crates. The following is his version of the description of the Facies Hip-
pocratica : — *' Ad ultima jam ventum esse testantur, nares acutic, collapsa
tempora, concavi oculi, frigidae languidseque aures et imis partibus lenitar
verse, cutis circa frontem dura et intenta, color aut niger aut perpallidus.**
Other unfavourable symptoms are also strikingly portrayed : — '* Mali morbi
testimonium est vehementer et crebro spirare ; a sexto die cepisse inhorres-
cere; pus exspuere; vix excreare; dolorem habere continuum; difficulter
ferre morbum; jactare brachia et crura; sine voluntate lachrimare; habere
huraorem glutinosum dentibus inhaerentem; cutem circa umbilicum et
pubem macram, prscordia in6ammata, dolentia, dura, tumida, interna, ma^
gisque si hxc dextra parte, quam sinistra est ; periculosissimum tamen est, si
vens quoque ibi vehementer agitantur/'
Aetius and Oribasius, like our author, borrow almost every thing from Hip-
pocrates and Galen.
Rhases and Avicenna, particularly the latter, treat of the prognostics in
Pever very fully. Avicenna, like Hippocrates, sets down deafness as an un-
^vourable symptom. Pringle, on the contrary, states it as rather a fa-
vourable one. On this point, my own experience inclines me to lean to the
side of the ancients. Dr. Russel found deafness an unfavourable symptom
of the Plague at Aleppo, 1760. Hippocrates had stated, that Jaundice com-
ing on before the seventh day, is un&vourable ; but Averrhoes affirms, that
sill the Indian and Persian physicians reckoned it a favourable symptom.
IRhases considers yellowness of the skin an unfavourable symptom, unless
the Fever be of a bilious nature. Alsaharavius says, it is an unfavourable
complication when it does not prove critical. He states it as a dangerou:}
symptom, when the patient lies on his back with his legs drawn up. This
agrees with the Prognostic of Celsus — ^ Mors denuntiatur ubi aeger supinus
cubat, eique genua contracta sunt.'' Avicenna and Averrhoes, state it as a
£ital symptom, when the patient sinks down in bed and exposes his hands
and feet. Averrhoes, Comment, in Cantica Avicenna.
Prosper Alpinus g^ves an admirable account of the Prognostics in diseases.
— See nis work, de prasagiendd morte et vitd agrotantium, passim. He
agrees with the ancients, that deafness is an unfavourable symptom, unless
it occur at the time of a crisis. Like the ancients, he considers the absence
of thirst an unfavourable symptom in ^ardent diseases, as indicating that the
system is insensible of its wants.
y. HOW TO KNOW WHETHER THE DISEASE WILL BE OV LONG
DURATION.
Celsus thus states the Prognostics of a protracted Fever : — '' Signa qu»-
dam sunt, ex quibus coUigere possumus, morbum, etsi non interemerit, lon-
gius tamen tempus habiturum : ubi frigidus sudor inter febres non acutas
circa caput tantum, et cervices oritur : aut ubi, febre non quiescente, corpus
insudat : aut ubi corpus modo frigidum, modo calidum est, et color alius ex
alio fit; aut ubi, quod inter febres aliqua parte abscessit, ad sanitatem non perve-
nit; aut ubi aeger pro spatio parum emacrescit : item si urina modo liquidaet
puraest, modo habet qua^dam subsidentia; si Isevia atque alba rubraque sunt^
qos in e& subsidunt; aut si quasdam quasi miculas reprssentet; aut si bul-
lulas excitat."
Galen has given a full exposition of these symptoms in his Commentary
on the Prognostics of Hippocrates, from which Aetius, Oribasius, and our
author have borrowed largely. Rhases, Avicenna, but most especially Haly
174 COMMBNTART ON THE 8BC0ND BOOK.
Abbas, treat at great length of this subject. See also Averrhoes' Commen-
taries on the Cantica of Avicenna.
VI. HOW TO KNOW WHETHER THE DISEASE WILL TERMINATE BT
A CRISIS OR BT A RESOLUTION.
A SIMILAR Statement is made by Aetius, v. 22. See also Averrhoes, Com-
ment, in Cantica Avicenna.
VII. ON THE CRITICAL DATS.
The father of medicine, who was profoundly skilled in Semeiology, appears
to have attached great importance to the observance of the Critical Days.
At first, as Galen remarks, he seems to have been undecided respecting cer-
tain days, and, accordingly, he gives a somewhat different account of them
in his Prognostics and Aphorisms from what he has done in his Epidemics.
His latter list of Critical Days differs little or nothing from that of Galen. .
Galen reposes such confidence in the doctrine of Critical Days, that he ^
affirms, that, by a proper observance of them, the physician may be able to '
prognosticate the very hour when a Fever will terminate. The following i&
his List: — ^The 7th is particularly favourable; next, the 14th; next to these,
the 9th, 11 U), and 20th ; then, the 17th and 5th ; afterwards, the 4th, 3d, and
18th. The 6th is very doubtful and unfavourable; the 8th and 10th, like the
6th ; the 12th, 16th, and 19th, like the 8th and 10th. Intermediate between
these two lists of Favourable and Unfavourable days, is the 1 3th. He informs
us that Diodes and Archigenes held the 21st to be particularly favourable,
but he agrees with Hippocrates in rejecting it, and adopting the 20th.
Celsus follows the system of Archigenes. He says, '' Kpurifioi dies erant,
dies tertius-quintus, Septimus, nonus, undecimus, quartus-decimus, unus et
vicesimus; ita ut summa potentia septimo, deinde quarto-decimo, deinde
uni et vicesimo daretur.'' But he does not hesitate, afterwards, to express
his distrust in the whole system; for, he adds, ''verum in his quidem anti-
quos tunc celebres Pythagorici numeri fefellerunt; cum hie quoque medi-
cus non numerare dies debeat, sed ipsas accessiones intueri.'^
The Greek writers subsequent to Galen adopt his system, with little or no
alteration. Aetius arranges the Critical Days thus : — First in order, the 7th
and 14th; then, the 9th and 11th; next to them, the 17th and 5th; then, the
4th; and afterwards, the 3d and 20th. The 6th is usually bad.
The Arabians, with scarce one exception, adopt the Galenic system. Avi-
cenna, who treats of the Critical Days very fully, mentions the list of them
given by Hippocrates and Galen, and also that by Archigenes, but decides
in favour of the former.
Rhases mentions the Critical Days in the following terms: — ^The 3d is cri-
tical in very acute fevers ; the 4th is indicative of the 7th and 6th ; the 5th is
favourable; the 6th, generally unfavourable; the 7th is a particularly favour-
able or unfavourable crisis ; the 8th, rarely critical, but, if it be, unfavourable;
the 11th, critical and indicative of the 14th; the 12th, rarely critical, and like
the 8th; the 13th, rarely critical; the 14th, critical and favourable; the 15th,
like the 13th; the 16th, like the 12th; the 17th, like the 9th, and indicative
of the 20th; the 18th, rarely critical, or unfavourable; the 19th, rarely criti-
cal, or, if so, not bad; the 20th, next to the 14th, and favourable; the 21sty
sometimes critical, but less frequently so than the 20th ; the 24th, resembling
the 20th; after these, the 27th, 31st, 37th, and 40th, are critical. Averrhoes
remarks, that great deference is due to Rhases* opinion upon this subject,
C'OMMSNTARY ON THE S£COND UOOK. 175
since it was confirmed by experience, in more than ten thousand cases, in an
Infirmary (in infirmaria Relenson). His list is very little different from that
of Galen. In bis Continensy he gives an account of the systemof Arcbigenes,
but states that he prefers that of Hippocrates. Lib. xxxii.
Averrhoes states, that the medical world was divided between the systems
of Archigenes and Galen, but he inclines to the side of the latter in this case,
although on most occasions given to dispute his authority.
Avenzoar, upon the whole, nearly agrees with Rhases, but expresses him*
self undecided with regard to the 20th and 21st days. His authority must
also be allowed to be bf great weight upon this subject, if we may believe
Averrhoes, that he lived to the age of one hundred and thirty-five, and practised
medicine from his fortieth year.
To the first class of Critical Days, according to Haly Abbas, belong the 7th
and 14th; to the second, the 11th and 20th ; to the third, the 4th, 17th, and
21st; and to the fourth, the 3d, 5th, 9th, and 18th.
Alsaharavius gives a similar list to Haly's. He inclines rather to (he 20th
than the 21st day.
Galen, and most of the ancient authorities, believed that the Critical Day^
are influenced by the moon. Dr. Mead zealously defends this doctrine.
Nihel says, "I dare venture this bold assertion, viz. — that the observations
of the ancients on Crises have never yet been publicly proved false or preca-
rious, or our neglect of them properly justified by any author.*' On the I*ulse,
p. 76. The truly learned and modest Van Swietan, after the fullest investi-
gation of the subject, came to the conclusion, that the ancient doctrines with
regard to the Critical Days are founded on nature and experience. Comment.
§ 587. See an interesting dissertation on the Critical Days in the works of
Bordeu. There is no end to quoting authorities upon both sides of the ques-
tion. Van Helmont is one of the most decided antagonists of the ancient
doctrines; and Castellus, Boerhaave, Hoffman, Forestus, Cleghorn, Stahl,
and the late Dr. Robert Jackson — no mean authority upon any matter relat*
ing to Fever, — maintain the propriety of attending to the Critical Days, and
e^^pouse the opinions of the ancients with regard to them.
Prosper Alpinus gives a correct summary of the ancient doctrines respect-
ing the Critical Days, depra$, vita et morte agrot, vi. 4.
VIII. THAT CRITICAL SYMPTOMS APPEARING IN THE BEGINNING
ARE BAD.
The opinion here delivered is derived originally from Galen, but is
'Maintained also by Oribasius, and the other authorities. It requires no
Comment.
IX. HOW TO JUDGE OF A COMING CRISIS.
This chapter is copied from Oribasius, 5ynop. vi. 3. The subject is fully
^**eated of by Galen, de Crisibus. Rhases describes very accurately the
Symptoms of an approaching crisis, such as, confusion of the understanding,
Vertigo, headach, inquietude, involuntary flow of tears, pain of the stomach,
^c. He warns the inexperienced not be alarmed at the violence of the pre-
cursory symptoms, de Ke Med, x. 26. Avicenna, Averrhoes, Haly Abbas,
^nd Alsaharavius, though they treat of the subject very fully, supply no ori-
ginal views.
See an ample account of the ancient opinions in Prosper Alpinus, rfcpr<f^
^'*ta et morte O'grot. lib. vi.
176 COMMENTARY ON THB SECOND BOOK.
X. HOW TO RECOGNISE A PRESENT CRISIS.
This is taken with very slight alterations from Galen, Therup. ad Glauc.
lib. i. See also, de Cruibus, iii. 2. The critical evacuations enumerated
by Galen are, those by vomiting, by the belly, by urine, by sweats, by
hemorrhage from the nose, by hemorrhoids, by the menses in women, by
abscesses of the parotid glands, and by determination to the knees, feet, or
some other part not vital. He says, there are three ways in which a fever
may terminate favourably, namely, by an evacuation, by an imperfect crisis
without an evacuation, and by resolution, that is to say, when the febrile
symptoms gooff gradually.
There are likewise three unfortunate terminations ; for, the patient may
die suddenly with much agitation, or in consequence of a metastasis, or he
may be slowly wasted by a marasmus.
Averrhoes enumerates the same kinds of critical evacuation as Galen, and
otherwise treats of them very judiciously. CoUiget. iv. 39. Avicenna gives
a long account of all the circumstances attending the Crisis, but he copies
closely from Galen and Hippocrates, lib. iv. fen. 2. tr. 1. Haly Abbas, in
like manner, is sensible ana correct, but borrows from the Greeks, Theor,- x,
10. The account given by Rhases is excellent, but it differs little from our
author's. Ad Mamor. z. 27. In his Continent, he gives a full exposition
of the Galenic doctrines, with his own Commentaries. He states, that a
Crisis may take place in six ways ; by hemorrhage at the nose, by an alvine
evacuation, by vomiting, by a discharge of urine, by a sweat, or by an apos-
teme, Lib. xxxi.
XI. HOW TO DETERMINE WHETHER A PAST CRISIS BE PAVOURABLB.
This requires no Commentary. See, however, more fully Galen and
Rhases, u, $,
XII.-— ON THE PULSES, FROM THE WORKS OF GALEN.
The ancient authorities on the Pulse, are the following : Celsus, iii. 6.
Galenus, Ubellus de puisitnts ad Tirones, de different, pvlsuum, de dignoscen-
dibus pulsibus, de causis pulsuu?n, de prasag. ex puis., Si/nopsis librorum dt
pulsibus. — Philaretus, de pulsu. — Actuarius, Meth. Med. i. 9. — ^Avicenna, lib.
i. fen. 2. doc. 3. — ^Averrhoes, CoUig, iv. 16. — Haly Abbas, Theor, lib. vii.— -
Alsaharavius, Theor. tr. vii. — Rhases, ad Mamor. x. 32. Continens, lib. xxxi.
— Psellus, Opus Medicum apud Boissonade, Anecdota Graca,
Prosper Alpinus, gives an excellent exposition of the ancient doctrines on
the Pulse, de pras. vii. et morte agrot. iv. 3. — Le Clerc's account is not so
accurate. Hist, de la Medic, Wetsch is tolerably correct, de Pidsu,
Hippocrates does not appear to have attached much importance to the
observation of the Pulse, for he generally neglects to mention its characters,
and that even, where we would most expect to find them stated, as, for ex-
ample, when he is detailing the symptoms of Epidemical Fevers. Celsus,
too, expresses himself in doubtful terms respecting the indications (uniished
by the Pulse. — '' Venis enim maxim^ credimus, fallacissimae rei ; quia s«pe
ists leniores, celerioresve sunt, et setate, et sexu, et corporum naturi; et
plerumque satis sano corpore, si stomachus infirmus est, nonnunquam etiam
mcipiente febre, subeunt et quiescunt; ut imbecillus is videri possit, cui
OOmiBNTART ON THB SBCONO BOOK. 177
bdle laCuro gravis Mstat aoccssio. CooUra saepe eas concitat et resolvit sol,
et balneuDiy et eaercitatio, et metus, et ira, et qualibet alius animi afiectut.''
Aretseus and Cselios Aurelianus are indeed sutiScieotly minute and accurate
in detailing tbe characters of the Pulse, while describing the symptoms of
various diseases^ but neither of them has written expressly on the subject;
and, as the works of Ueiophilus and Archigenes are entirely lost, Galen must
be considered as our first and great authority on tlie Pulse — i night almost
have said our sole authority, for all subsequent writers were content lo adopt
his system, without the slightest alteration. As our author's account is pro-
fessedly taken from the elaborate treatises of Galen, it may, perhaps, appear
uuneoessary for me to attempt any further exposition of the system ; but the
importance of the subject, and, I may add, its novelty to modem readers,
have induced me to make some detached observations upon it, in order to
explain some parts of it which are confessedly obscure, and to answer cer-
tain objections which have been stated against it, by modern writers who
have not properly understood its principles.
Van Helmont, although compelled to admit the ingenuity of Galen's sys-
tem, pretends to differ from him respecting the final cause of arterial action
and respiration, which, he maintains, is not refrigeration but the preservation
of animal heat. (Operoj p. 112.) But, if he had read Galen's Work, de
Um Re$pirmtumi$j carefully, he would have found that this is the very sense
which Galen attaches to the terms Refrigeration and Ventilation. Van Hel*
mont states, as a new discovery, that a sort of concoction of the blood takes
place in the left Ventricle of thie Heart. But he might have found this doc-
trine also in the Works of Galen.
The first distinctions of the Pulse are derived from the extent of tbe Dias-
lole, according to its three dimensions, namely, length, breadth, and depth.
These give rise to the characters, longy broad, and deep or high, (he Cierc
renders the last by ElevL) A long Pulse, of course, refers solely to the im-
pression on the finger, as in reality one Pulse cannot properly be said to be
longer than another ; but when a person is lean a larger portion of the artery
can be felt under the finger than when he is fat.
The character deep or high is easily understood, and is evidently produced
by a free dilatation of the artery. It does not indeed appear evident how
there can be a difference between a deep and a hroad Pulse, if the dilatation
of an artery were equal on all sides ; but Galen positively affirms, that it is a
feet ascertained by ample experience, that sometimes there is a free dila-
tation of the artery upwards with a contracted one laterally, constituting a
fiigh and narrow rulae ; and, on tbe other hand, that there is often a free
dilatation laterally with a contracted one upwards, constituting a low and
ifroad Pulse. He gives directions for detecting these peculiarities of the
artery. De Dif. FuU. iii. 2.
The eharacters o£ quick and slow are derived from the length of time occu-
pied in the actions of ssrstole and diastole. They seem to be sufficiently
well marked, and yet Fyens denied that there is any difference between fre^
pauy and quicknisi. However, many of our late authorities in medicine
acknowledge a distinction between these two characters, and they appear to
me sufficiently obvious.
The distinctions of strong and feeble are derived from the force with
which the artery strikes the finger. No one can possibly mistake them.
The relaxation and constriction of the arterial tube give rise to the charac-
ters of soft and hard^ which are so obvious that they cannot be misunder-
stood.
The next class of Pulses derive their characters from the time which elapses
^tween two diastoles or pulsations of the artery. They are called dense and
N
176 COMMBNTABT ON THB SBGOND BOOK.
rarcy in the ancteot system, being uied in the same lense thotyre^aini^ and
tkw are in modern works.
The terms equal and unequal (or^ as they might have been translated,
equabU and unequable)^ arise from the constancy or inconstancy of any pe-
culiar character of the arterial pulsation. The rtgular and irre^Uar arc ois-
tinguished from these, inasmuch as a seiies of pulsations, alth^igh unequal
mar be regnlar, when they observe a certain raUo, as when four strong pul-
sations are succeeded by a feeble one, and this series goes on successiTely.
An inequality may take place in respect to one pulsation ; for, the dilatation
of the artery may be interrupted, and then completed, when it is called dor-
cadiiunUy eaprixafUy or goat-leap; or, the stroke may be suddenly repeated,
when it is called dicrotosj which may be translated the double^ reverbenU*
lag, or rebounding Pulse. The term dorcadissans is derived from dorcas^ an
animal generally supposed to have been the goat, but as Harris, in his Na-
tural History of the Bible, remarks, it was probably the Gaaelle; and, in
the Latin translations of Avicenna and Haly Abbas it is rendered GaMelUmt,
It is said that, when this animal leaps upwards, it at first takes a short
spring, then seems to make a sudden stop, and afterwards takes a much larger
and swifter bound. This character was applied to the pulse when an imper^
iect dilatation of the artery is succeeded by a fuller one. It is thus descrio«i
by Haly Abbas : — ** Gazellans pulsus est qui cum a celeritate indpiat ante-
quam percussiat stat, dehinc velociter movetur : vocatur autera hujusmodi
gazelenus suli ex similitudine caprioli saltu : quum capriolus quern Oazel Ara-
bic^ vocant cum saltum dederit pedes toUit et suspensus pauco videtur ten^
pore atque sic ad terram velociiis redit.*' The translator of Alsaharavins renders
It by Fusalis, It is correctly stated by Fouquet that the second pulsation is ne-
cessarily larger than the first. The Dicrotos consists of two pulsations, follow-
ing npon one another so rapidly as to form, as it were, but one beat of the
artery. In the translation of AUaharavius it is called Maliearu, and is thus
defined : — ** Est autem pulsus mallearis qui percutit manum etr8cedit,deiude
redit et percutit secundario.'' We shall have occasion presently to compare
it with the Pulsus Dicrotos, or Redoubling Pulse, of Solano and Nihell.
When there is a succession of pulsations which diminish in magnitude re-
gularly, such a system of pulses are called Myuri — that is to say, decurtaie
or sharp^ailed, from their supposed resemblance to the tapering tail of a
mouse. Those who are acquainted with the Scholiast on Hephcstion, and
the other ancient writers on Prosody, will readily recognise a term with which
they are familiar. Of these Pulses, some end in complete Asphyxia, and
hence are called swooning, f ailing^ or fainting Myuri (Le Clerc rendera it by
le Myurm dtfaillant); and others again gradually recover their foimer
magnitude, and are called recurrent Mjpwi, Nearly allied to these are the
innucntcs ct circumnuentes, for which it is scarcely possible to find any ap-
propriate term in English. Le Clerc thus renders and explains this pulse,
in French : — ^ Le My urns qui va en baisumt de chte et d^mUre^ €*est a dire
qui frappe moins sensiblement le premier et le dernier doigt que celui on
ceux du milieu.'* It consists, in fact, as Avicenna explains, of a double
Myurus, which swells out in the middle, and diminishes at both extreaiitiee.
The Myurus, and the Innuens et Circumnuens, are thus described hf Hake
Abbas : — *' Est autem et in hac specie unius pulsationis pulsus qui wmru
Cauda appellatur; quique inclinus vocatur pulsus. £t qui muris cauda vo*
catur fit cum arteria dilatatur sub primo digito qui a superioribus est grana,
et sub secundo minus grossa, sub tertio parva, sub quarto minima. Imclimm
autem pulsus est qui sub duobus mediis movetur digitis grossus et sub ex-
tremis nine et inde sobtilis et tenuis ; aut medium ejus elatum est, et extiemi-
tatis demissae, videturque tangenti arterise extrema ad infonora declinari."
Sprengel appears to have thought that the pulsus inclinus of Haly Abbas i
COMMBNTART ON TBI 8BCOND BOOK. 179
one 6ril deteribtd by him, but there can be no doubt of its being identical
with the innuemei eirctimimefu{petmtKmsKaifrtpaf€vevK»f)ofQ9Xen*9 System.
Ib the Spasntodic Pulse, the artery is said to convey the sensation of a string
or cold tigiitly strelehed, which, When touched, starts from its place. It seems
to be the Ptiktu Torlvoiiif of Alsaharavius, and is commonly met with when
oooTokooDS w» impending.
The Vikrmtmy deriTes its name from an imaginary resemblance to the mo-
tions of a rod or dart when thrown into the air, and it can only take place
when the artery is haid^ and the strength good. Le Clerc renders it U pauU
dmrdtmi.
The Vndulaiory derives its name from a supposed resemblance to the roll-
ing of the waves, and can only take place when the arteiy is particularly soft,
being acoompaiiied with an unequal elevation of it in the diastole, it is thus
described by iihases : — ^Undosus veroestqui secundum latitudinem, magnum
digiti occupat locum, cum lenitate et tepletione, cum eo tamen non est mag-
na elevatio neqne subita, sed videtur quod elevationem ejus una post aliam
contingit, donee it ut undis assimilatur, quarum una aliam sequitur." Ije
Clerc rendeis it ontkwant.
■Ob rtrwmmlmliSen from the last-mentioned only in magnitude and
streDgtl^ being soft, small, and weak. Nearly allied to it is the Formtcam
or awl^-lifcgpulBe, which is one of the last degree of weakness, smallness, and
densil|r. They are thus described by Khases : — **^ Verraicolosi forma est ut
forma tmdosi, in elevatione qu« secundum diastolem eadem invenitur, non
tamen est latus, neque plenus, cujus inundatio existit debilis, qui vermibus
per Ibnunen avteris discurrentibus assimulatur : formicans vero pulsus adeo
invenimr in ultimo parvitatis, et spissitudinis consistere, ut pulsui pueri re-
cois nati assimnletur." The Chinese compare the Formicans to a silk
thiead, aeapiilary tube, or a hair.
The luUrmittcnt and Intercurrent pulses are opposed to one another, there
bfing a oamplete £ukire of a pulsation in the one case, and an accessory or
superfluous one in the oth^ . There cannot be a better proof of the imper-
fection in our modem systems of the pulse, than that there should be no men-
tion in them ef the Intercurrent pulse.
The Hectic pulse, it is well known, is small and dense.
The-Sorra^eri is hard, quick, and unequal in its feel. Hhases says that it is
principailj observed in inflammations of tlie Pleura and Diaphragm. Le
Clerc fenders it It pauk -en maniere de »cie. Hi»t. de la l^led. p. iii. l.iii.
c. 3. It appeaiB to correspond with the pulse called harsh in the works of
EagiiBh writ/en on medicine.
Berdea speaks af the terms ^/armiraiu, rm/urus^ and caprizam^ as having
been jnatly bMiished from our modem nomenclatures. But it may be doubted
whether it be faam superior inifbrmation or from ignorance that we have re-
jected theae nice disdnctions. Some of these terms were in use long before
the time of Galen ^he mentions that HerophiUis used the term dorcadUsa'M)^
and ibr mare than a thousand years afterwards the characters of the pulse to
which they were applied vrere acknowledged as real; and, on a matter de-
pending-solely upon experience and observation, the concurring sufTrages of
80 many ages must be admitted to be entitled to some considei'ation. That
maay of the Gteek and Ajrabian physicians were men of great learning, and
<»f nradi fMracticalekill in medicine, cannot admit of a doubt; and therefore the
opinions of such men ought not to be hastily rejected as visionary and un-
fomided. Galen, indeed, expresses in strong terms the difficulty which he
^d in defining accurately the states of the artery to which the terms we are
irvftting of are applied, and warns the reader that such characters are to be
<^t6cted only by a person well experienced in the art of feeling pulses, which
^ pronoonces io be one not easily attained . It is worthy of remark, further,
n2
180 COMMENTARY ON THE SECOND BOOK.
that the truly learned and experienced Prosper Alpinus recognized and de-
scribed these characters of the pulse, De Pr. Vit et Morte .^Igrot,
Whoever will consult Galen s treatises on the Pulse will find discussed in
them many subtle questions which are now seldom thought of. For example,
he enters into a disquisition, whether or not we can perceive the systole of the
artery. He informs us that Agathinus had denied, and Herophilus affirmed,
the possibility of this. He, after having, as he says, exammed the matter
fully, agrees with the latter.
Psellus gives the characters of the Pulses in not inelegant Leonine verses.
The causes which produce all these varieties of pulse, and the changes of
the system which they indicate, are, upon the whole, pretty clearly explained
by our author ; and the reader who wishes to consult other abridgments of
the doctrines of Galen may find them in the works of Rhases, Haly Abbas,
and Actuarius. I shall merely make a few remarks upon some of the more
obscure and least understood parts of the system, and compare it with a
celebrated modem Theory of the Pulse.
Respecting the Myuri, Galen states that they all indicate a prostration of
the vital powers, but differing in degree, according to circumstances. When
the pulse gradually becomes smaller, and in like manner recovers its magni-
tude gradually, and so on alternately, so as to form the Recmrent Myuri, it
indicates an inferior degree of prostration ; and, when the diminished state of
pulsation continues permanent, a greater degree of oppression is indicated.
In the former case the powers of the system seem able to struggle against the
load, but in the latter they are completely overcome. This state is next in
danger to that of complete Asphyxia. These three are the worst kinds of
pulse. The Intermitting is said by Him to be allied to these, being indicative
of great danger, though inferior to that of those we have mentioned. Next to
the Intermitting is the Intercurrent, which indicates that the powers of the
system are strong, but oppressed, and contending against some great load.
Galen was particularly apprehensive of the Intermitting pulse, which he held
to indicate that the system is struggling against some urgent cause. He re^
marks, however, that, when the pulse is otherwise strong and frequent, it in-
dicates less danger than when it is weak and slow. But, upon the whole, he
considered this kind of pulse so full of danger, that he affirms he liad
never known a person recover whose pulse intermitted during the interval of
two pulsations. When the pulse intermits during the space of only one pul-
sation, or a little more, he says he had often seen the patient recover. He also
states, that an Intermitting pulse is less dangerous in old persons than in
adults or children. Some, he says, affirm that they have seen cases of inter-
mission which did not prove dangerous, but he believes that they had con-
founded rarity with intermission. The Intermitting is to be distinguished
from the Rare by the length of the time of rest, and by the latter being often
equable, whereas the former is always unequable. He says it is generally oc-
casioned by frigidity of the heart. These opinions respecting the danger in-
dicated by an Intermitting pulse were called in question by the celebrated
Solano de Luque, who maintained that it is always indicative of a Critical
Diarrhnea. Dr. Nihell, who is a warm abettor of Solano*s doctrine, while be
contends that the Intermitting pulse often indicates a Critical Diarrhoea, allows
that there are exceptions to this rule, for that it often arises from disorders and
impediments of the heart and its blood-vessels, and is sometimes brought on
by spasms, convulsions, weakness, or repletion of the heart. According
Bordeu, the pulse which is indicative of a Critical Diarrhcea, or disorder i
the bowels, is irregular, unequal, and bounding, as well as intermitting; an
he therefore thinks that Solano did not sufficiently attend to its other charac
ters besides its intermissions. Judging from my own experience, I woul
say, that the Intermitting pulse deserves in general the character which Gale
COJIMBNTART ON TBS SSCONO BOOK. 181
{^ives it, although in certain cases it is merely indicative of Intestinal irritation.
I also think it not improbable, that Solano and Nihell may have sometimes
confounded the Irregular and Unequable pulses with the Intermitting; and
Galen decidedly inculcates that the former indicate the presence of Bilious
matters in the primee viae, and prognosticate a Critical vomiting.
Galen, Rhases, and Haly Abbas, repeatedly inculcate that the Undulatory
Pulse indicates an approaching crisis by a sweat. They describe it as being
strong, iiill, soft, bounding, and unequable. This, I am disposed to think, is
the same as the Pulsus Inciduus of Dr. Solano, and the unequally Rising
Pulse of Dr. Nihell, which they represent to be indicative of a Critical sweaty
and describe as consisting of two, three, or four pulsations, rising not only
above the rest, but also gradually as they proceed aoove each other, the second
above the first, and so on. Bordeu represents it as being plein, soupUf deve-
lope, megaUf &c. and holds that it is different from the Undulatory Pulse of
the ancients. It seems probable, however, that they are identical. Wetsch
says that it is called Pulsus lledundans in the Chinese system of the Pulse.
Medic, ex Puis, c. 7.
The Dicrotos is distinguished by a smaller pulsation suddenly succeeding
to a larger one. Galen compares it to a hammer, which, when forcibly struck
against the anvil, rebounds, and strikes it again. The artery in such cases is
always strong and vibratory. Philaretus describes the pulsation as being
bard, vehement, and rebounding. Galen says it can only occur when the
powers of the system are strong, the artery hard, and the body oppressed
with a redundance of humours. He repeatedly inculcates that it indicates an
approaching crisis. There can be no doubt that this is the Double or ite-
bounding pulse of Solano and Nihell, which, according to them, is always in-
dicative of a Critical hemorrhage at the Nose. Whether it uniformly pre-
cedes this crisis, and no other, I cannot, from my own experience, pretend to
determine. Nihell's statement is strong in favour of this prognostic. Of one
hundred and twenty-one persons in whom he observed tlie Rebounding pulse,
seven only showed no tendency to hemorrhage ; the remaining one hundred
and fourteen were all affected either with bleeding at the nose, or symptoms
of determination to the head. But, according to Bordeu, it is only when the
pulse is hard, full, and briskly bounding, that it indicates a hemorrhage at the
nose; for, when it is less hard, less full, and less briskly and steadily rebound-
ing, it rather indicates a discharge of mucus or phlegm from the nose. I
lately detected the Rebounding pulse in a case of Uterine hemorrhage during
pregnancy.
'Die singular pulse called dorcadissanSf which we have translated Goat-leap,
is said to occur most frequently in affections of the Heart and Inflammations
of the parts within the chest. I think I have detected it in such cases.
The Vermicular appears to have been the same as that which is now some-
times denominated Creeping in modem works, and is said by the ancient
authorities to occur in cases of sudden prostration of the vital powers, pro-
duced by inordinate evacuations, such as hemorrhage, cholera, diarrhoea, and
the like.
The pulse called innuens et circumnuens is said to occur only in cases of
extreme debility and danger.
Galen gives the following ingenious explanation why the pulse is con-
tracted and frequent, in cases of acute inflammations. lie remarks that, if a
person have- an inflammation in a limb, he will experience most ease in a
state of complete rest ; but, if obliged, by some urgent necessity, to perform
a journey, he will find, that he can accomplish this most easily by taking
short and frequent steps. In like manner, when any part is inflamed, it
Would afford most relief, if the motion of the arteries could be altogether
suspended for a time; but, as this cannot be, nature renders the dilatation
1S2 COMMXNTART ON THE SECOND BOOK.
as confined as possible, and makes up for its smallness by frequency. — He
U$u Respirationis.
After giving this exposition of the Galenic system of the pulse, we may
well exclaim with Vander Linden : — ** Si qui alii de pulsibus post Galenum
scribunt, ne illi videntur actum agere T — Manuductio ad Medtcirunn,
XIII.-^ON THE ALYINB DI8CHAROB8*
See, in particular, Hippocrates, Prognast, and Galenus, de CriiUmSf c. xi.
Galen remarks, that the stomach may do its office properly, but that, owing
to the heat of the neighbouring parts, the moisture may be dissipated, and
the contents of the bowels rendered too dry ; or that, owing to an imperfect
distribution of the chyle, they may be too liquid. When the alfine discnarges
are soft and consistent, we are certain, that both the digestive and distributive
functions are properly performed, and likewise, that no part within the belly
is in a state of inflammation. He afterwards makes many other ingenimis
observations on this subject, the importance of which, towards the restoration
of health, is now generally admitted. He remarks,, that, agreeably to the
description of Hippocrates ( Prognost,) the proper ailvine evacuation ought
to be yellowish; ibr, if very yellow, it indicates the presence ef too modi
bUe, or, if it do not partake of that colour at all, it indicates that the passage
of the bile to the intestines is stopt. Hhases and Avicenna concur in tms
remark. Mr. Abemethy, by the way, insists, that the colour of the fkces de-
pends principally upon the bile. — (On the Comtitutional Treatment of Local
Viseases.) Galen describes the frothy evacuation, which appears to be the
same as the one resembling yeast described by Dr. Paris. — (On Diet, p.
333.) Hippocrates (Progn,) and Galen make mention of a discharge,
which consists of small, hard, and convoluted portions. This discharge Is
also described by Dr. Paris, u. s. Galen is of opinion, that it is occasioned
by constipation and heat of the bowels.
The account of this subject given by Haly Abbas ( Theor, vii. 16. and
X. 10.) is excellent, although principally collected from the Greek wrHen.
An unctuous discbarge, he remarks, is occasioned by a melting of the &t If
it be viscid at the same time, it indicates also a wasting of the principel
members. A firothy discharge proceeds from heat and flatulence. A grees
eracuation indicates immoderate heat, and the presence of bile. Black die-
charges consist either of black bile, or of common bile blackened by im-
moderate heat This, he says, is the worst appearance of all. If blood is
discharged after the fteces, it may be supposed to come from the small i»>
testines; but if before, from the large; and if mixed with the freces, it
probably comes from the intermediate parts. — See also Alsaharaviusi, Theor,
tr. ix. and Rhases, Cant, xxxi. Rhases states, that white faeces arise from
jaundice. When the discharges are watery, the nourishment of the body is
stopt.
The opinions of Hippocrates and Galen on this subject are conecdy
stated and explained by Prosper Alpinus. De Pressag, Vita et Motte JEgrot,^
lib. vii. c. 11.
XIV. ON THE INDICATIONS VROM THE URINE.
See Hippocrates, Prognost, lib. ii. et de Vict. Acut. c. 46. — Galeni
Comment, de Crisibtis, i. 12. — Celsus, ii. 7. — ^Theophilus de Urinis, — ^A<
tuarius de Urinis, — Aetius, lib. v. — ^Avicenna, lib. iv. fbn 2. tr. 1., Cantic,
1. — Averrhoes, Colliget, iv. 21. — Haly Abbas^ Tkeor, iv. 12, x. 10. — .
OOMMSNTABT ON THE SSOOND BOOK. 188
haraviusy Theor. tr. viii. — Rhaseti, ad Mantor. x. 30. and Contimuij lib.
xxxiw — Psellus, Offut Medicu$n.
Of the ancient authorities who have treated of the urinary discharget,
Theophilas and Actoarius are most particularly deserving of attention ; out
their works contain so many minute obsenrations, that I cannot do justice
to them within the limits to which I am obliged to restrict myself. I must b«
content, therefore, with making a few remarks. Besides the watery portion,
the ancients distinguished three dbtinct substances in the urine, — 1st, TImi
hypostasis or sediment, which is the part that falls to the bottom,--*2d. The
ensBorema, or substances which float m the watery part, but have not weight
to subside,— 3d, The nubeculs, or cloud-like appearances seen floating on the
snr&ce. They state, that the urine of sedentary persons has more sedi-
ment than that of persons who pursue an active course of life ; that the urine of
womm, ffom this cause, has generally more sediment than that of men ; that of
children, more than that of adults ; and that of persons who live grossly,
than the arine of temperate persons. Of the varieties of sediment, Uie fari-
naceous and furfiiraceous, are said to be particularly unfavourable in febrile
complaints, but that sometimes they merely indicate local affections of the
kidneys.
As a specimen of the doctrines of the Arabians, although, in fact, entirely
borrowea from the Greeks, I shall select a few of the observations of Haly
Abbas and Alsaharavius. According to Haly, thinness of the urine in-
dicates deficient digestion. Thickness, on the other hand, is the product of
excessive digestion, or arises from the presence of pituitous humours in the
body. When the sediment is white, it is a favourable symptom ; when
yellow, it is from yellow bile ; when red, it is from a sanguineous plethora
and imperfect digestion ; and if of long continuance, it roust proceed from
in^mmation of the liver. If, after intense redness, the urine become black,
it is a most fiUal symptom. When the urine is moderately fetid, it is con-
nected with indigestion ; but when very fetid, with putrefaction. Alsal»*
ravins delivers the characters of the different kinds of urine in nearly the
same terms. He properly cautions the physician not to allow himself to be
imposed upon by the colour of the urine, which may sometimes acquire a
tinge from the patient's having taken saffron, cassiarlistula, or the like.
Such tficks, he says, are often practised upon water doctors. According to
Rhaiee, it is ao un^vourable symptom when the urine does not become
tmrbid ki the course of the fever. Yellow urine without sediment is said to
be unfevovrable.
Prosper Alpinus has stated correctly the doctrines of Hippocrates and
Galen, but is entirely silent respecting those of Tbeophilus and Actuarius,
u. f .
Besides the ancient authors referred to by us in this chapter, the works
of the following writers de Urhus exist in manuscript, but have never been
publisiied : — 1 . Abicianus, quoted by Labbeus. — 2. Athenaeus, quoted by
Ou Cange, ex Cod. Colbert^ 3614. — 3. Constantinus Africanus, in Bibl.
Cdsiorea. — 4. Joannes Episcopus, Cod. Reg, 3497. — 5. Maximus Planudes
ftnd Meletins Monadius, Cod, Reg, 3175. — 6. Nicephorus Blemmydes^ ia
Bibl. C^sarea, — 7, Anonyraus, &c. Cod, Colb, 3614 and 4230, et in Bibi.
Qtesar,''^. Piropulus in Bibl, Corsliniandy p. 448. — See Fabricii Bibl.
Grac. t. xiii. p. 779.
XV. ON THB INDICATIONS PROM THE SPUTA OR XXPBCTORATIONS.
Galen has treated fully of this subject in his work, de CrisibttSy ii. 10. —
See also Hippocrates, Frognost.9nd Coaca, and Celsiis, ii. 0. Aetius is
>
184 COMIiXNTART ON THK SKCOND BOOK.
somewhat fuller than our author, ▼. 52. — See Avicenna, lib. iv. fen. 2.-*-
Averrhoes, Cantk. p. i. tr. 2. — Ilaly Abbas, Theor. vii. and x. 10. — Rfaases
ad Mansor. x. 24.
We shall be content with giving a few of the observations of the Arabians,
of wh€>in Haly is the most full and accurate upon this head. The lungs and
the other parts within the chest being the organs of life, when affected* they
occasion inflammation of the heart. Expectoration indicates some affection
of those parts. When the expectoration is thin and small in quantity, the
disease is not concocted ; when the sputa are of moderate consistence and
equable, the disease is at its acm^ ^ when thick, it is certainly on thedecline.
Thinness indicates, that the humour which occasions the coinplaint is of a
subtle nature ; thickness, tlie contrary. Blackness indicates vehement beat.
Green sputa are indicative of the presence of green bile, white of phlegm,
and redness of blood. When fetid, they proceed from putrefoction. Black
sputa indicate great danger.
Prosper Alpiniis makes many ingenious remarks on the chaiacters of the
sputa. De Vita tt Marte JEgrot, lib. vii. 19.
XVI. — ON THB DIAGNOSIS AND CURB OF BPHBMBRAL FBVERS.
Among all the records of medicine, there is not, perhaps, any thing more
valuable than the reports of febrile diseases, contained in the Epidemics of
Hippocrates, illustrated, as they fortunately are, by the learned Commentaries
of Galen. Many of them are histories of Ephemeral Fevers, brought on by
certain exciting causes, and frequently terminating in Synochous. The
Procatarctic causes generally assigned are, fatigue, excessive debavcbery,
exposure to extreme heat or cold, and the like.
Of no disease has Galen treated so frequently and fully as of Ferer. —
See de Diff. Febriumy Meth. Med. viii. and ix., Therap, ad Giauc^ de
CrisibuSf ii. 13. et alibi. He everywhere inculcates, that Ephemeral Fevers
are affections of the SpiritSy by which he seems to have understood the heat
and gases contained in the blood. The exciting or remote causes of them,
according to him, are, want of sleep, indigestion, sorrow, fear, anger, anxiety,
tlie application of heat and cold, excessive fisitigue, tumour of the groin, and
the like. He remarks, that the heat in these fevers is not offensive on the
first application of the fingers, but conveys an acrid sensation after a short
time. (By the way. Sir John Pringle makes the same remark respecting the
Jail Fever.) He has particularly stated constriction as a proximate cause of
fever ; and this evidently is the same as the spasm of the extreme vessels in
the Cullenian Theory of Fever. In this variety, he approves of venesection,
unless the patient be a child or a very old man. In the other cases, his
most approved remedy is the Bath ; but his treatment is judiciously varied,
according to circumstances. For example, when the Fever arises from the
depressing passions, he forbids to use hard friction and frequent baths, and
merely directs to pour tepid oil over the patient's body. When it is pro-
duced by exposure to heat, he forbids to use much oil, or to have recourse to
hard friction, and directs to pour upon the head water which has been
cooled by means of ice, and to put the patient into a cold bath. Alexander,
however, finds fault with him for giving heating medicines, such as pepper,.
and using hot applications over the stomach in such cases. Alexander s ac —
count of the nature and treatment of these fevers cannot be perused with to<^
liiuch attention. They arise, he says, from many and various causes, sucl^
as repletion, want, watchfulness, fatigue, disorder ofthe belly, apostemes; and .9.
in a uord, from all the procatarctic causes. When the fever is occasioned b_
f xcessive fatigue, the indication, he slates, is to supply mobture to the bod^
COMJISNTAET ON THB 8BC0ND AOOK. 186
ratlier ilian take from it. Ilence, all friction with discutieot oiU ouglit to be
avoided ; and what is used for rubbing the body should be mixed with
much water ; but the principal dependence is to be put upon the tepid bath.
Here, again, he thinks that Galen erred, in not directing that the oil used for
rubbing the body should be diluted with water.
Oribasius and Aetius treat of Ephemeral Fevers in much the same terms as
our author.
Palladius says, that Ephemerals are affections of the spiritt, arising from
some external exciting cause, such as fatigue, intoxication, anxiety, watchftil-
oess, or from a tumour of the groin. Celsus ^ves a similar enumeration of
the causes, but in briefer terms : — *' Febris ex uguine, Tel ex lassitudine, vtl
ex spstu, aUi&ve simili re est.** Almost all the authorities ftx>m Hippocratet,
downwards, mention enlargement of the glands, especially those of the groin,
among the causes of fever. Agathias the historian remarks, that Pestilential
Fever is attended with enlargement of the inguinal glands, but does terminate
fiivoorably in one day, like the Ephemerals. Hitt, lib. v.
Nonnus enumerates nearly the same causes of these fevers as our author,
whom he appears to have followed closely. He remarks, that Ephememk
are sometimes protracted to the third or fourth day, from which it appears
that the term is not to be taken in too strict a sense.
Synesius treats of Ephemeral Fevers with great accuracy, so that we have
reason to regret that the text of this author should be so corrupt. Like pre>
ceding author^ he enumerates, among the exciting causes, abscess of the
glands of the groin, neck, and armpits, the beat of which, he says, being de»
tennined to the heart, kindles a fever. In this case he recommends discu-
tient and emollient applications, such as mallows, linseed, and the like. The
account given by Constantinus Africanus is exactly similar to his.
Actuarius mentions the same causes, and briefly recommends the same
treatment as our author.
Haly Abbas gives a most distinct and accurate account of the phenomena
of Ephemeral Fevers, according to the nature of their remote causes. The
Isi Class are produced by external causes, such as exposure to the heat of
the sun, hot baths, or astringents which occasion constriction of the pores of
the skin. He also inculcates that these causes may likewise nve rise to Sy«
nochous, or Putrid Fevers. The 2d Class are prod uced by calemcient food and
medicines. The 3d Class are occasioned by immoderate exercise, or violent
passions, such as anger, fear, and the like. The 4th are sympathetic affec-
tions proceeding from inflammatory swellings of the glands. He remarks,
thai in certain kinds of fever the increase of heat is not felt upon the first ap-
plication of the hand, owing to constriction of the pores. Theor. viii. 3. l£s
treatment merits attention. When tlie fever arises from a hot cause, he di-
rects to pour refrigerant liquids, such as vinegar, rose oil, and the like, upon the
beady and to apply to tlie forehead a cloth moistened with the same. When
tlie fever is produced by cold, he recommends the warm bath, with friction,
in order to promote perspiration ; after which caleiacients may be given ; but
he forbids wine, if the exciting cause be great, lest it should occasion a con-
version of the complaint into a Putrid Fever, which, as he remarks, Galen
stales not to be an uncommon occurrence. To prevent this, he recommends
to have recourse to venebection and the liberal administration of diluents.
The next class of Ephemerals of which he treats are Intestinal Fevers origi-
nating in errors of food and drink. For these he recommends cooling
drink, cooling articles of food, clysters, eccoprotics, and the like. When
the fever is brought on by violent labour, he recommends the tepid bath,
(gentle friction with emollient oils, light food, and a spare allowance of wine,
provided the patient has been habituated to it. When the fever is produced
by violent emotions of the mind, he recommends the tepid bath, refrigerant
186 comfBHTAmr on tbx sbcond booi^.
ibody camphor, and the like. When it ari8<^ firom sorrow, he directs to have
recourse to treatment of an exhilarating nature, the bath, wine, and so forth.
For fever brought on by vrant of sleep, he recommends soothing treatment,
the atfiision of tepid water, and wine, if the patient has been accustomed to
it. In fevers arising from glandular swellings, he directs to have recourse to
venesection, and forbids the use of the bath and of wine. This is somewhat
different from our author's treatment. The account of the causes and treatment
of ephtmerals given by Alsaharavius is so like that of Haly Abbas, that I shall
not enter particularly upon it. *Serapion, Averrboes, and Avenzoar, give sensible
expositions of the causes and cure of these fevers; but there is little in them
worthy of attention that is not derived from the Greeks. Avensoar states
distinetlTy that, if neglected or mismanaged, they are apt to be converted in-
to potrio, or synochous fevers. For ephemerals occasioned by labour, he re-
comrncods the tepid bath, and friction with the pulp of melons. Avicenna
remarks, that if, in ephemerels, the blood become inflamed, the fever is apt
to be converted into sjmochous, or, if it become putrid, into putrid fever.
This, he says, is particularly the case, when the ephemeral fever is connected
with obstruction of the pores of the skin. For the cure of this species, he
approves of venesection. He recommends the same remedy, when the
disease arises from drinking too much wine, or from aposteme of the groin,
armpits, or neck. His expositor, Syrasis, particularly commends the tepid
affusion in ephemerals. Ithases joins in enforcing the same practice as
Avioenna. He gives a most comprehensive account of the causes of these
fevers. Like all the other authorities, he decidedly inculcates this important
feet, that, although ephemeral fever be in itself neither serious nor ratal, it
may be converted into a vehement and acute fever, when any error is com-
mitted in the regimen or method of cure. Constriction, he says, may take
place, either in the pores of the skin, or in the internal parts, and is gene-
rally occasioned by cold or astringents. This is one of the causes of fever.
The others are, immoderate exercise, the application of heat, food of a heat^
ing nature, and putridity.
A "^cording to Prosper Alpinus, the Methodists held, that the proximate
cause of fever is constriction. Galen, as we have stated, held this to be one
ofnhe causes, but not the sole one. The Methodists, like our Cullen and
Hoffman, seem to have generalised too much. Their most approved re-
medies were the warm bath, and friction with emollient oils. De Mediema
Methodica, lib. v.
The earlier modem writers on medicine give the same account of ephe-
merals as their ancient masters, whose views in all cases they servilely adopt.
— nSee Rogerius, Tract, iii. and Platearius de FebrUmt, Rogerins correctly
remarks, Uiat ephemeral fever, from enlargement of the glands, is merely
symptomatic. The causes of ephemerals, as enumerated by him, are, ex-
posure to extremes of heat and cold, food and drink of a heating nature,
strong exercise, violent passions of the mind, and the like. Platearius re-
marks that, if an ephemeral be prolonged beyond the third or fourth day, it
is apt to be converted into a putrid fever.
XVII.— ON PUTRID FBVBES.
Tnis chapter is mostly taken from Oribasius, Synop, vi. 7. Many of the
histories in the £pidemics of Hippocrates are Synochous Fevers, accom-
panied with putrefaction of the nuids. Galen remarks, that they occur
principally in persons of a plethoric and gross habit of body. Meik, Med,
nb. viii. According to him, Putrid Fevers may either arise from the con-
version of ephemerals, or originally from putrefaction of the fluids within the
COMMSIITAET ON THB SSCOND BOOK. 187
vessels. De Dijf, Feh» i. 9. Aetius steles, that they arise from coDstrictioo
of the skilly or viscidity of the humoure, whereby the perspiration is st«pt,
and the quality of the Titai heat so altered, as to give rise to putrefactioB,
first of tlra fluids, and afterwards of the &t and solid parts. When these
corrupted fluids are oootained within the vessels, they occasion Synochoos
Fevers ; but, when distributed over the body, they give rise to Intermittenls.
lib. V, 74. Synesius and Constantinus AfHcanus give a similar accoanl.
Alexander gives an interesting and ingenious disquisition on the origin and
nature of Putrid Fevers, one of the most common causes of which be holds to
be the conversion of Ephemeral Fevers. This is the account of them given
by moet of the other authorities, both Greek and Arabian, so that I need not
enter into any very circumstantial exposition of their views. I shall
merely give the brief account of them nimished by Palladius. There are,
he says, two kinds of Synochous Fevers, the one being occasioned by e^
ferve&cence, and the other by putrefaction of the blood ; of these, the latttr
are the more protracted and dangerous. In them the pulse is contracted,
the heat pungent, and the urine white and putrid. Among the Arabiaiis,
see, in particular, AJsaharevius, lib. xxxii. §. 6. — Haly Abbas, Theor, viiL 5.
and Rhasee, Conthensy lib. xxx. Rhases states, that Putrid Fevers art
often engendered by eaung too much fruit, such as peaches. He says, they
generally b^n with depression of the pulse, horripilation, torpor, aod
sonmolaicy.
XyiII.*^-*ON THB CVBB OF PUTBID FBVBB8.
All subsequent writers on this subject are indebted to Galen, for laying
down, in the most satisfiurtory terms, the principles upon which the treat-
ment of Putrid Fevers ought to be conducted. He particularly recommends
bleeding ad deliquium. When this evacuation is neglected, the patient's
only chance of safety is from a spontaneous hemorrhage, or profuse perspin^
tio«. He is so confident in the remedial powers of venesection, that he di-
rscts it to be performed as late as the seventh day, and even later, if the
strength of the patient permit. He particularly directs, likewise, to allow
the patient to drink as much as he chooses of the coldest water, whidi, Im
says, when seasoasd^y administered, is most efficacious in extinguishing the
febrile heat. This remedy, however, he says, is to be used with becoming
caution. But, upon the whole, he strenuously inculcates, that the safety of
the patient depends upon the free use of phlebotomy and cold drink. When
the fever abates, he allows wine. Alexander, although sufficiently disposed to
difii&r ftom Galen, entirely concurs with him in opinion respecting the
treatment of Putrid Fevers, for which he particularly commends bleeding
and cold driak. When venesection is contraindicated by the weakness of
the patient, he is to be treated by a refrigerant and diluent regimen.
Aetius and Oribasius follow Galen, and their treatment, fiierefore, agrett
perfectly with our author's. Synesius and Constantinus Africanus agree la
recommending bleeding and cold drink. But, when the patient is very
weak, they forbid to have recourse to the former, and, in that case, direct to
use gentle aperients, and medicines of a refrigerant and diluent nature, socb
as prunes, ittjufoes, pur^ain, and the like.
Although Avicenna lays little claim to originality, his plan of treatment io
diis case is deserving of attention, as being directed by the soundest iudfp^
ment. He begins with venesection, if the patient's strength permit, and thmi
opens the belly genlly, but cautions against violent purging. He then gvn$
first diuretics, and afterwards sudorifics. Unless vrnen the stomach is loaded
with crudities^ he approves very much of cold drink. Though fevourable to
188 COMMSNTART ON THE SECOND BOOK.
the seasonable practice of venesection, he forbids it, except at the commence-
ment ; and directs to proportion the loss of blood to the strength of the pa-
tient, lie also forbids to interfere with the crisis by bleeding, purging, or
giving gross food at that season. Further, with regard to venesection, he
does not approve of abstracting much blood at once, which may occasion a
dangerous prostration of strength ; but prefers taking a moderate quantity,
and repeating the operation, if necessary. The pui*gatives which he most
commends are tamarinds and myrobalans; but, when these are not suf«
ficiently strong, he permits to give scammony, aloes, and colocynth. He also
directs to give camphor as a refrigerant. It is to be kept in mind, that the
Arabians held the action of camphor to be frigorific, that is to say, narcotic.
He is most minute \n his directions about the diet. For drink, he gives
barley-water, with a small proportion of wine or vinegar.
Haly Abbas lays down the rules of treatment with great precision. He
recommends venesection at the commencement, provided the fever be of a
sanguineous type ; but, if the patient be debilitated, he is to be treated with
refrigerants.
Averrhoes treats of Putrid Fevers at great length, and with more than his
usual judgment ; but, as he differs but little from Avicenna, we shall not at-
tempt to give an abstract of his practice. Collig, vii. 9. Rhases gives a full
account of the practice of the Greeks. When the extremities are cold, and
the pulse weak, he directs to rub them, in order to draw off the blood from
the mternal parts.
The practice of Dr. Robert Jackson in Putrid Fever was very similar to
that of Galen and other ancient authorities. He approved of bleeding, of
rubbing the body with stimulant and antiseptic substances, and afterwsirds
of giving grateful wines, such as the Rhenish and Champaigne.
Alexander Aphrodisieus inquires how it happens, that wine, which is of a
hot nature, proves useful in fever. The amount of his speculations upon this
matter is this, that the wine acts by strengthening the powers of the system.
Probl.
All the ancient authorities disapprove of the bath, except in the decline of
the fever. — See Ugulinus de Balneis, Rabbi Moyses says, that the use of
it is to be regulated by three circumstances: — 1st, That no rigor be pre*
sent. — 2d, That no important member be affected. — 3d, That there be no
crudities in the veins. These appear to be very judicious regulations.
XIX. THE DIAGNOSIS OF TERTIANS.
Hippocrates relates many interesting cases of Tertian Fevers in his Epi-
demics. He attributes their origin to bile. De Natura Humana^ c. 29,
Celsus describes two kinds of the Tertian, the one beginning with shivering,
and being succeeded by heat, the paroxysm returning every alternate day;
and the oth6r constituting the Semi-tertian, of which we will have to treat
afterwards.
Galen treats of these Fevers in different parts of his works, as, in Hippo-
crat. Epideni. Comment,, Therap, ad Glattc., de Different, Feb. ii. 3., de
TypiSf c. 3. The symptoms of tne Tertian are thus described by him: — It
is attended with intense thirst, heat, acrid and bilious vomitings, loss of ap-
petite, and restlessness. For the most part, these symptoms are preceded by
rigors, or sometimes by extreme coldness. The pulse in Tertians b small
and dense. At first, the night preceding an attack is past in a restless state,
but after the disease is prolonged this is not the case. The urine is yellow.
In many parts of his works, he announces it as his decided opinion, that the
Quotidian Intermittent is produced by phlegm ; the Tertian oy. yellow bile ;
COMMBNTART ON THB 8KC0ND BOOK. 189
and the Quartan by black bile. This theory of Interraittents was adopted, in
a word, by all his successors. — See Oribasius, Synop. vi. 9. — Aetius, v. 80. —
Nonnus de FebribuSy c. 6. — Palladius de Febr, c. 6.*-Alexander, lib. xii. 6.
-nSynesiuSy c. iii. — ^Avicenna, lib. iv. fen. 1. tr. 2. — Haly Abbas, Theor.
lib. viii. — Serapkm, vi. 13. — Avenzoar, iii.tr. I.e. 2. — ^Averrhoes, CoUig.
iv. 28.
Sprepgel informs us, that Professor Eisner adopted the ancient theory of
Intermittents, according to which the Tertian is supposed to arise from bile,
the Quotidian from phlegm, and the Quartan from black bile. Hitt. de la
Medic,
Mr. Cleghorn's observations on the bodies of more than a hundred per-
sons who died of Tertians confirm the accuracy of the ancient tlieory with
regard to them. He mentions, that he constantly found tlie Vesica FeUea
full and turgid, and the stomach and intestines overflowing with bilious
matter. Dit, of Minorca,
XX.-— ON THB CURB OF TERTIANS.
Hippocrates recommends generally purgatives at the commencement,
and afterwards the hot bath, and trifoly, assafoetida, and wine, to promote
perspiration. De Morbis,ii.39.
Celsus informs us, that Cleophantus treated Tertians, by pouring warm
water upon the patient's head, and giving him wine before the accession of a
paroxysm. This, however, he considers to be precarious practice. Upon
the whole, his great dependence is upon these three remedies, vomits,
purgatives, and wine, of which the first is to be tried on the third day, the
second on the fifth, and the third on the seventh.
Galen's practice is exactly detailed by our author. He evacuates the bile
upwards and dovmwards at the commencement, and also with the same in-
tention administers diuretics and sudorifics. After these, he reposes great
confidence in wormwood, which, indeed, all the ancients held to be a power-
ftil cholagogue. He also approves much of the tepid bath of common water.
He forbids wine until after the fever is concoctea, but afterwards allows a
small quantity of a thin watery wine. The food is to be refrigerant and
diluent. Every thingot a heating and acrid nature is to be abstained firom.
Aetius, Oribasius, and Nonnus, conduct the treatment upon the principles
laid down by Galen. Actuarius directs to bleed at the commencement.
Alexander discusses the established principles of treatment freely and
fiilly. He disapproves of Galen's practice of giving the decoction of worm-
wood in the Genuine or True Tertian, after the seventh day, and confines
the administration of it to Spurious Tertians, when he mixes it with oxymeL
His own remedies are of a diluent and refrigerant nature. He approves
very much of the bath. He speaks highly of die good efiects of grapes and
peaches, and still more of water-melons given with cold water before the fit.
He approves of gentle, but not of strong purgatives.
Synesius recommends cooling articles, such as damascenes, gourds, &c.but
says nothing of wormwood. Constantinus Africanus also omits to make
mention either of wormwood or the tepid bath. He permits, however, to
pour water on the head, and to put the feet into hot water.
Serapion directs to give emetics, if the matters are determined to the
stomacn, and clysters, or gentle purgatives, if to the bowels. He recommends
to give myrobalans afterwards, and then wormwood, but not until the mor-
bific matter is concocted. Tr. vii. 13.
Hhases recommends gentle and cooling purgatives, with refrigerant and
190 COMMKMTABT ON THB SBCONB BOOK.
diluent drinks, containing sorrel, cucumber, camphor, &c. Ad Mansor,
z. 4.
Avicenna*8 directions are exceedingly minute, and seemingly very judi-
oious. He cautions against using drastic porgatives, and expresses himself
doubtfully of the effect of ?enesectioo. His practice consists principally in
the administration of gentle purgatives, diluent and refrigerant medicines.
He approves of pomegranates, plums, and water-melons. Averrhoes lays
down the same princijSes of practice. CoUiget,r\i. It. ilaly Abbas states,
that, as it is the nature of these fevers to occasion heat and dryness of the
body, they are to be treated with diluents and refrigerants. Agreeably to
these principles, he directs to give clysters and gentle laxatives, to use the
tepid affusion, and the like. Pract, i\i. 12. Alsaharavius recommends si-
milar treatment. Uhases, like Haly, recommends refrigerants and diluents.
He approves of cooling purgatives, such as a combination of myrobalans and
scammony, or a draught made from prunes and manna. He speaks favour-
ably of emetics. Several of his authorities recommend the bath, and others
approve of wormwood. ContinenSy lib. xxx.
It will be remarked, that many of the ancient authorities recommend the
tepid baih for the cure of Tertian Intermittents. Prosper Alpinus informs
us, that he had seen this practice successfully pursued by the Egyptian physi-
cians. De Med. Mgypt.
XXI.— -ON SPURIOUS TXBTIANS.
Galen explains, that Tertians are called Spurious or Bastard, when the
symptoms assume ao anomalous character. He states correctly, that they
are generally connected with disease of the spleen. His practice, which is
consistent with his views of the nature of the attack, is similar to our author's,
that is to say, he recommends venesection and fomentations at the com-
ntencement, and afiterwards things of a hot penetrating nature, such as worm-
wood and pepper, which he, no doubt, gives with the intention, that they
sbcrald act as deobstruents. Here, again, Alexander cautions against the indis-
criminate adoption of Galen's practice, affirming that these calefacient medi-
cines sometimes proves dangerous, by increasing the inflammatory action.
Almost all the other authorities, however, adopt the views of Galen. — ^See, in
particttlar, Oribasius, Synop* vi. 11. — Aetius, v. 81. — Nonnns<fe FebrUmty c.
5. Avicenna, in like manner, recommends at first venesection and clysters;
and afterwards deobstixient medicines, such as wormwood and pepper. Haly
Abbas directs to treat Spurious Tertians like True, at the comnofebcement.
After their acm6, he strongly recommends wormwood, but forbids to give it
eariier. It acts, he says, by increasing the strength of the stomach, opening
the pores, increasing the urine, and promoting the secretion of bile. He ap«
proves of wine in the decline of the Fever, with the view of supporting the
strength, and of promoting the urinary and cutaneous secretions. He, there-
fore, directs that the wine be white, and not too old. Prttct. iii. 13.'
From the account of the ancient practice in cases of Tertians, as given in
this and the preceding chapter, it will be seen, that the use of bitters in these
diseases was well understood formerly. Their beneficial effects are now ge-
nerally acknowledged. Dr. Cullen says, — " 1 hold it to be established as a
ftu:t, that both astringents and bitters, in their simple and separate state, have
proved often sufficient to prevent the recurrence of the paroxysms of inter-
mittent fevers ; and that tney more certainly do so when combined together.''
Materia Medica, ii. 92.
Dr. Thomas informs us, that he had known many cases of intermittent
fevers which yielded to quassia, after having resisted the powers of cinchona.
COMMINTABT OM THE 8KC0MD BOOK. 191
• *
He agrees with the aqcieiito in recommend ing stonacbic biuers and dii^
retics for removing scirrhosity of the liver and spleen, brought on by ioier-
mitteat foveiB. The use of pepper for intennittents has been much cried up
by the American and Italian physicians of late. They affirm that it is mofft
eiiicacious than cinchona.
XXII. ON THB OIAONOBIB OF dUABTANS.
Wjb mentioned in the 18th chapter, that the ancients held Quartans to be
occasioned by an accumulation of black bile, lience, says Hippocrates^
tb^ prevail most in autumn, and attack persons between the ages or twenty.-
five and foity-five. De ^at. Hum, c. 29. lie recommends principally for theoB
emetics, purgatives, and the warm bath. De Affect, c. 1 9. By wandering feven^
of whidi mention is made by our author, is meant fevers, the paroxysms of
which return after an interval of many days. — See llippocr. Epidem. — Rhases
ad Mamor, z. 8.
Our author*s description is condensed from Galen (Tkerap. ad Glauc,
lib. i.)y or probably copied direct from Oribasius {St^nop. vi. 12.) Galen
states, that Quartans are of a less inflammatory nature than Tertians, and
hence the pulse is slower and smaller. liuf!us (Ap. Aetii lib. v. c. 83.) rfr*
fers the origin of certain Quartans to the spleen ; and, no doubt, it is fre-
quently diseased. Alexander says, that Quartans arise from yellow bile
overheated, or from feculent blood, these humours being lodged either in the
vessels or in the spleen. Palladius, Nonnus, Synesius, and, in a word, all
the Greek authorities, give a similar account of the nature of Quartans. Con*-
stantinus Africanus says, that a paroxysm lasts for 24 hours, and is succeeded
by an interval of 48 hours. The urine is at first white and watery, but is
the decline becomes black. Ue mentions, that it is connected with induitr
tion of the spleen.
As there is nothing original in the theory and descriptions which the
Arabians give of Quartans, we shall not enter upon them minutely. Avenw
hoes states, that the fever invades with a great sense of cold, so that tlie par
tient's teeth chatter. The colour of the urine at first inclines to green, or is
somewliat white; but afterwards it becomes gross, black, or reddish. The
interval between the paroxysms is two days. The most of those affected with
Quartans have disease of the ^leen. AJsaharavius gives exactly the sam^
account of these fevers. Avicenna*s description is most ample and coiiipre>-
bensire, batcootaim no additional facts to those we have already mentioned.
Ualy Abbi% Aventoar, and Rhases, in like mannner, adopt the views of the
Greeks.
XXIU.— ON THE CUBS OP QUARTANS.
Tbis chapter is copied from Oribasius, Synop, vi. 13. Galen, however, is
the great authority upon this subject. With respect to venesection, he directs
to have recourse to it only when there is a plethora of blood ; but recom-
mends, when a vein has been opened, and the blood found to be black and
thick, especially in the case of diseased spleen, to abstract blood until it
change its colour. He approves of laxatives, and clysters, at first emollient,
*^iid afiberwards acrid. He forbids to use those things which were supposed
to engender black bile, and recommends a thin white wine. He speaks fa-
vourably of pepper. When the disease is come to its acm6, he recommends
^o rectify the state of the viscera by fomentations and cataplasms, and by ad-
<^inislering melanogogues, especially hellebore, in such quantity as to operate
^.o-""'
COMMXNTARY ON THS 8SC0MD BOOK. 193
Fe?er, is at great pains to explain the manner in which putrid extra?asated
Phlegm gives rise to Quotidian, lie represents the heat as being smothered
and concealed like that of moist fuel. Celsus describes all the varieties of
the disease very minutely. Constantinus Africanus gives an accurate de-
scription of this intermittent. He says that the paroxysm lasts for 24 (18 ?)
hours, and is followed by an interval of 6 hours. First, old persons, and
then boysy are said to be peculiarly subject to the disease, which is apt to
make its attack in cold countries and at cold seasons of the year. It is at-
tended with a great degree of cold, especially of the extremities, the face is
swelled, the colour pale, and no thirst is present.
As the Arabians give the same account of the origin and symptoms of
Quotidians, we need not enter upon a detail of their descriptions. All agree
that they are connected with Phlegm as an exciting cause, and that the Fever
is less ardent and well marked than in the case of Tertians.
XXV. — ON THE CURE 09 QUOTIDIANS.
This chapter is taken from Oribasius, Syn^pn. vi. 14.
Celsus enjoins abstinence for three days; after which, food is to be taken
every alternate day. After tl>e fever has subsided, he recommends the bath
and wine.
€ralen*s treatment is exactly the same as Our author's. Alexander, as usual,
makes nice distinctions as to the circumstances under which each of the
neroedies ought to be applied. In general, he approves of incisive and at-
tenuant medicines, but blames Galen for recommending the latter too in-
discriminately. He forbids cataplasms and embrocations at the commence-
ment, lestihey should occasion a determination of the humours to the affected
part.
Synesius appears to have proceeded upon much the same principles as our
author, but he makes mention of some additional medicines, such as camphor,
wormwood, and the like.
Nooous recommends, at first, things of an incisive and attennant nature,
and then emetics, after which, the phlegm is to be purged by means of colo-
cynth and agaric, and cataplasms and fomentations are to be applied to the
pit of the stomach.
Avicenna lays down the rules of treatment with so great minuteness, that
I cannot venture upon an abridgment of them. His prracipies, however,
seem to be the same as those of Galen. Averrboes recommends, for the 6rst
seven days, medicines of an incisive, attenuant, and deobstruent nature. He
then directs to give cathartics which evacuate phlegm, such as turbith,
agaric, and hiera picra, but forbids the use of colocynth. He approves very
much of friction, the mode of applying which is minutely described by him.
Bhases recommends much the same treatment. He, in particular, directs to
give turbith and agaric along with wormwood and mastich. Haly's remedies
are mostly diluents and attenuants. Alsaharavius recommends the same
remedies as Rhases.
XXVI. ON THB HBPIALUS, AND RIGOR WITHOUT HEAT.
Hippocrates applies the term Hepialus to a Fever occasioned by Ame-
norrfacea. Galen enters minutely into the consideration of the nature and
^^ises of the Hepialus, which appears to be a variety of the Quotidian In-
^fmittent. He says the fever derives its origin from the putiefaction of a
o
9»
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COMMENTARY ON THB 8BCONO BOOK. 195
symptoms. He also remarks their tendeDcy to terminate in Dysenteries,
Lienteries, and Tenesmus.
Gralen marks a distinction between the Continual Terer (<rw€xos) and the
Synochus, which it is necessary that the reader should particularly attend to.
He remarks that there are three varieties of Intermittents — the Quotidian,
which arises from putrid phlegm ; the Tertian, from yellow bile ; and the
Quartan, from black bile. Of Continual Fevers, arising from yellow bile,
there are two species, the one being called Synochi, and consisting of one
paroxysm from oeginning to end, and the other, to which the generic appellap
tion Continual (<jvp€xut) is particularly applied, and which consists of a
number of particular paroxysms. Of the Continual Fevers, some assume the
Tertian type, having a remission of the fever every alternate day ; some the
Quotidian, and have a remission every day ; and others, of rare occurrence,
resemble the Quartans, in having remissions after an interval of three days.
De Diff. Feb. ii. 2. In another place, he says of Synochous Fevers that they
consist of two varieties, the one arising from an ebullition of the blood, and
being produced by the conversion of Ephemerals, and the other arising from
putrefaction of the blood in persons who are gross and plethoric. Metk*
Med. lib. ix.
Aetius treats of Continual Fevers (avv€xfis) in nearly the same terms as
our author, and distinguishes them from the Synochi.
Alexander states that the Continual Fevers (oxfyc^^ts) differ from the In-
termittents, solely from the humours which occasion the former being of a
thicker nature.
Our author's account is nearly copied word for word from Oribasius.
Actuarius remarks, that the Synochus proceeds from an ebullition of the
blood, and the Continual Fever {avv€xr}s) from putrefaction of the different
humours.
Nonnus states very distinctly tlie difference between the Synochus and
Continual Fever. In the latter, he says, there is an incomplete remission of
the febrile symptoms, but in the former there is no remission at all.
Synesius and Constantinus Africanus adopt the distinction between the
Synochus and Continual Fever, as stated by Galen.
Celsus, although he does not describe the Febres Continue very particu-
larly, seems to allude to them in his account of the Quotidians : — *' Rursus
aHs sic desinunt, ut ex toto sequatur integritas; alise sic, ut aliquantum
3uidem minuatur ex febre, nihilominus tamen qusdam reliquiae remaneant,
onec altera accessio accedat ; ac saepe alias vix quidquam aut nihil remit-
tant, sed ita ut continuent."
In the works of Rhases, the distinction between the Continual and Sy-
nochous Fevers is clearly pointed out. lie states that the Synochus, or Con-
tinenSf is a Fever which consists of one paroxysm from beginning to end,
whereas the Continual, called awexrjs by the Greeks, and F. Contimui by
the Romans, is allied to the Intermittents.
In the barbarous translation of Alsaharavius, there is some difficulty in
recognising this distinction. He first describes a Fever, which he denomi-
nates Synocha, which arises, he says, from iDflammation of the blood, and is
marked by redness of the face, headach, and difficulty of breathing. 2d,
Nearly allied to it is the Synochus or Febris Continua (it ought to be JP.
Continens), which arises from putrefaction of the blood. 3d, The Febris
Quotidiana Continua, the Febris Tertiana Continua, and the Febris Quar-
tana Continua, which are distinguished from their corresponding Intermit-
tents by being attended with a partial remission and not a complete inter-
mission of the Febrile symptoms.
Avicenna describes the Tertian Intermittent by the name of Febris Ter-
tiana Periodica, and the Continual Tertian by that of Tertiana Continua ;
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COMMENTARY ON THE SECOND BOOK. 197
Therap, ad GUiuc, lib. i. He forbids the Bath when inilammatioD is pre-
sent, ifyg.
Aetius conducts the treatment upon the same principles as Galen, and the
directions which he gives for the application ot the different remedies are
most important, lie states most decidedly, that, unless venesection is had
recourse to, the patient will be in the utmost danger, and can only be saved
by tlie strength of his constitution, or some critical evacuation. When the
stomach is loaded, however, he forbids depletion, because, by emptying the
veins, the distribution of the crudities in the prima via will be accelerated.
When the Menstrual, or Hemorrhoidal discharge is expected, be directs to
bleed less profusely than otherwise. Persons of a hard, san^ine, and com-
pact habit of body, are said to bear bleeding best. In practising venesection,
he directs the physician to pay more attention to the strength of the patient
than to the period of the Fever. He is particularly earnest in recommend-
ing the use of cold drink. He directs to give it at the acm^ of the disease^
but not at the commencement. He forbids to administer it freely when there
is obstruction or inflammation of an internal viscus ; and states many serious
evils which may arise from the unseasonable administration of cold water^
although it be an excellent remedy when given at the proper time. With re-
gard to diet, he directs to give nothing but ptisan for tiie first three days.
On the fourth, he recommends to use the bath. Through the whole course
of the fever, the food is to be light, unless the powers of the patient be very
feeble.
As the other Greek authorities differ in no material respect from the prin-
ciples of treatment laid down by Galen and Aetius, we need not enter upon
any minute exposition of their views of practice. As a specimen, however,
of the practice of the later authors, we shall briefly mention that of Synesius
and CoBstantinus Africanus. They approve of bleeding, unless the stomach
be loaded with crudities; in which case, they forbid the operation until these
are concocted or discharged. They recommend diluents ; and, if the belly is
constipated, clysters, with decoctions containing tamarinds, damascenes,
manna, and the like. To remove the remains of the Febrile excitement in
the decline of the fever, they direct to give medicines of a refrigerant nature,
such as camphor, the seeds of melons, cucumbers, gourds, and the like.
Celsus jecommends venesection in all Fevers at the commencement, pro-
vided the patient is not very young, weak, or has crudities in his stomach ;
but af^er the fourth day he does not approve of it. He also makes some in-
genious remarks on the contrary methods of giving water and wine in cases
of Fever. He recommends the latter, when there is cold, torpor, and rest-
lessness. He likewise mentions the affusion of cold water and oil, with the
intention of changing the morbid state of action.
In an Epistle of Vindicianus, physician to the Emperor Valentinian, there
is an interesting history of a Fever, arising from indigestion and obstruction
of the bowels, brought on by excess in eating and drinking. In this case,
Vindicianus, in opposition to the advice of the other professional attendants,
would not administer a clyster, and gave his patient nothing but salt and
^ater, which procured first copious perspirations, and afterwards free evacu-
ations of the bowels. He then directed him to use the bath, and completed
the cure by giving wormwood to remove obstructions. This is a well-marked
case of Intestinal Fever. Fabricii BibL Grac.T. xiii.
Haly Abbas, during the first three days, strongly recommends venesection,
^bich, he says, will either have the effect of cutting short the Fever at once,
<)r of rendering it milder. His other remedies are altogether refrigerant, con-
sisting of acidulated drinks, and gentle purgatives, such as prunes, tamarinds,
'"^nd the like. Alsaharavius, in like manner, recommends depletion, and the
refrigerant plan of treatment.
198 COMMKNTART ON THE SECOND BOOM.
Serapion strongly recommends bleeding ad deliquium animi, which, he
says, will probably have the effect of procuring discharges from the bowels,
and of promoting perspiration. He admits of venesection even after the
sixth or seventh day, when other circumstances indicate it. He further directs
to administer refrigerant remedies, such as tamarinds, cassia-fistula, and the
like.
Averrhoes, although he approves of venesection, condemns Galen's direc-
tion to carry it the length of bringing on deliquium animi. He also cautions
against carrying the administration of cold drink too far.
Avenzoar strongly recommends bleeding ad deliquium. Avicenna like-
wise approves of this practice. When the strength does not permit to carry
depletion so far, he directs to open the Temporal veins, or to abstract blood^
by cupping. In such cases, he also recommends purgatives and refrigerant
medicines. Towards the conclusion of the Fever, be directs to give the Tro-
chisks of Camphor.
Rhases gives an excellent account of Synochus. His remedies are bleed-
ing, gentle purgatives, acidulated drinks, restricted diet, and complete absti-
nence from wine. He particularly recommends Aloes as a purgative. See^
in particular, Continens. lib. xxx. tr. v. c. 2. He approves of the bath, but
prefers delaying the use of it until the decline of the Fever. He is very de-
cided in recommending bleeding, unless the patient be of a weak constitu-
tion, or his system loaded with crudities. Alter the Fever is concocted, be
approves of giving cold water freely for drink.
XXIX. ON ARDENT FEVERS.
Our author's description of the Camus, or Ardent Fever, is taken from
Hippocrates, de Ratione Victus Acut, where the Commentary of Galen is
worth consulting. According to Hippocrates, the Causus is generally pro-
duced in the summer season, owing to the veins becoming dry and attracting
Bilious humours. In other parts of his works, he gives an account of seve-
ral varieties of the disease, differing considerably in character from that de-
scribed in the above-mentioned work. For example, one variety mentioned
in his Epidemics was distinguished by the absence of thirst and delirium, and
by the paroxysms occurring on the even days. See Galen's Commentary,
Operay Ed, Basil, T. v. p. 424. Also, de Morhis, i. 27.
Aretseus delivers a most striking description of Ardent Fevers, which I re-
gret that my limits prevent me from giving at full length. The following are
some of the most important symptoms : — the heat acrid and subtile, especial-
ly in the internal parts, desire of cold air and of cold things, the extremities
cold, the pulse dense and small, the eyes clear, bright, arid reddish; and, if
the Fever go on increasing, delirium, oblivion of every thing, lividity of the
nails, frequent respiration, profuse perspiration about the forehead and neck,
coldness of the body, and at last a complete collapse marked by a return of
,the powers of reason and certain indications of a prophetic spirit. This is
but a meagre outline of his matchless delineation of the phenomena of
Causus.
As all the Greek, Latin, and Arabian writers treat of Causus in nearly the
same terms as Hippocrates, we shall be very brief in noticing their descrip-
tions.— According to Alexander, there are two varieties of Cansus, the True
and the Spurious, the former being marked by intense thirst, bilious stools, .
tongue rough and black ; and the latter, by the thirst being moderate, the i
tongue not black, and the stools consisting not of bilious matters but rather
of corrupted food. The former kind is said to be occasioned by a Bilious,
and the latter by a Pituitous humour. Aetius describes the disease in Xhm
COMMBNTART ON THB 8BC0ND BOOK. 199
same terms as our author. He says that it is produced by putrefaction of
yellow bile. Palladius says that Ardent Fevers are occasioned by an Erysi-
pelatous inflammation of the Lungs, or by the putrefaction of Bilious hn-
mours which have become immoderately heated. The Arabians describe it
exactly as the Greeks. According to Avicenna, there are two varieties of
the disease, the Bilious and the Pituitoas. The inseparable symptoms of the
disease are, he says, concealed heat, roughness, and, at last, blackness of the
tongue. There is no perspiration until after the Crisis. For the most part
the heat is not strong in the external parts, but is particularly so in the in-
ternal. Rhases states, that the Ardent Fever called /on/o-or by the Greeks
belongs to the class of Tertians, only that in the former the heat is more in-
tense, and the paroxysms do not terminate in a complete intermission of the
Febrile symptoms. The symptoms, he adds, bear a considerable resem-
blance to those of the Tertian Intermittent, but are more strongly marked.
According to Alsaharavius, the Causus, or Ardent Fever, is occasioned by
heated bile collected in the veins adjoining to the heart, stomach, or liver,
and its symptoms resemble those of Tertians, but are more intense.
From the above exposition of the opinions of the ancients regarding the
Causus, or Ardent Fever, the medical reader will readily recognise its iden-
tity widi the Bilious Remittent Fever of Sir John Pringle and other English
authors. The ingenious Dr. Robert Jackson thus describes the symptoms
of the Fever, as they were manifested in his own person during a severe at-
tack of it : — ^** It had scarcely any remission, though it was fundamentally of
the remitting type ; the anxieties at the prscordia were inexpressible; the
distress scarcely supportable ; the sensation of internal heat was great, the
external heat little, if in any degree increased ; the abdomen was collapsed
and lank ; the pulsation of the descending aorta strong and vibrating ; the
pulsation at the wrist moderate in force, perhaps weak, and not much more
frequent than natural ; the tongue was parched and stiff; and together vrith
tiiis there was an abhorrence of drink, which appeared nauseous and oppres-
sive. The sensations were uncomfortable, the sense of burning was torments
ing, yet the surface was frequently damp, and, as judged by the touch, not
hot. The desire of something moist and cool was most urgent.'' On Tever^
p. 403.
Some late writers have confounded the Causus of the ancients with Syno-
cha, or Inflammatory Fever. But, as is correctly stated by Baccius, the
Cansns was decidedly of the Continual or Remittent type, and nearly
allied to the Tertian Intermittent. — De Thermis, Hoffman remarks, that it
Seldom appears in the more temperate parts of Europe, but is very common
in Asia, Greece, and Italy ; and hence the frequent mention of it in the
Works of Hippocrates, Galen, and Aretxus. Oper, T. ii. § 2, c. 2.
Homer says that the Dog-star brings many Fevers upon unhappy mortals
(^Iliad. xxi. 31 .); and his Commentator, Eustathius, remarks that the poet cor-
rectly refers the origin of Ardent Fevers to the heat of the Dog-days.
XXX. — ON THB CURB OF ARDBNT FBYERS.
Our author's directions respecting the treatment are mostly taken from
Xiippocrates, de "Rat, Vict, Acut. Hippocrates allows venesection only
Mrhen the attack is violent. He approves of the application of cold water to
tbe surface. Archigenes, as Aetius informs us, sponged the head and chest
with cold water during the acm^ of Ardent Fevers. Lib. iii. 169. His own
treatment, which is borrowed from Philumenus and Galen, consisted of cool-
ing remedies internally and externally, such as drinking cold water and
other things of a refrigerant nature, using cold applications, and the cold
,,.co«»
500
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COMMENTARY ON THK gBCOND BOOK* 201
ovdinary cases, he approves of giving cold water to extinguish the Fever,
but says that he has seen patients brought to imminent danger by the uiv-
seasonabie application of cold cataplasms and clysters.
Aetitts states that Fevers are kindled by the parts about the bowels, liver^
and lungs, being attacked with £rysipelas. Like our author, he approves of
cold drink, cool air, and cold applications to the part affected.
The acute affection of the Vena Cava, which is minutely described by
Aretsus, ought probably to be ranked with the diseases which we are now
treating of. De Morb, Acut, iii. 8. He recommends for it venesection
and the refrigerant plan of treatment. Cur. Marb, Acut. ii. 7. We have
stated in the preceding chapter that Palladius refers one variety of Ardent
Fever to Erysipelas of the Lungs.
A similar account of these affections is given by Avicenna, lib. iv. fen. i«
tr. 4, c. 13, 14, 15 ; and by Rhases, ad Mansor.n. 15, alib\que.
I can draw no information from modern works to illustrate the opinions of
the ancients respecting the Febrile affections treated of in this chapter. It does
not seem to be suspected now that Erysipelas ever attacks the Lungs or
Bowels ; and yet, as this disease when it occurs externally is known to be seated
principsdly in the Epidermis, and as the Epithelium, or membrane which lines
the internal cavities, is admitted to be a prolongation of it (see Kaau Boer-
haave, Perspiratia Dicta Hippocrati), it would seem probable a priori^
that the diseases of both portions of it should be alike. That Fevers are
often complicated with Ardent affections of the Lungs and Bowels, and
bilious appearances, we all adroit ; and it might be worth while to inquire
whether such diseases be of an Erysipelatous nature.
XXXIL DIAGNOSIS OF HBCTIC FBVBRS.
Ou& author has copied froro Oribasius (JSynop. vi. 21.), who in his turn is
indebted to Galen. (De Diff, Feb, i. 11.) A similar account is given in
Somewhat fuller terms by Aetius, v. 92. — See also Alexander, xii. 4. We
shall merely give his explanation of the characters of the pulse. It is hard
^nd small, because the vessels have become dry and contracted; — it is
<^eDse (frequent ?) because the necessities of the system required it to be so,
(namely in order to make up for the reduced expansion of the artery) ; — it is
^eeble, owing to the weakness of the vital powers ; — and slender, because die
Vessel does not admit of being stretched in breadth. Nonnus and Actuarius
<]erive their views from Galen. Palladius states, that the Hectic is an un-
ceasing Fever, wasting and consuming the natural humidity of all the mem-
bers, and supervening for the most part upon acute and ardent Fevers, but
Sometimes arising from syinpathy with some vital organ. He states it as a
characteristic of the Hectic Fever, that food increases the febrile heat, in like
^xianner as water poured upon unslacked lime unkindles heat. This com-
parison is borrowed from Galen, and is repeated also by Alexander and
Nonnus. Palladius, like our author, represents Marasmus as the termination
of the Hectic Fever. It is distinguished, he says, by prostration of the na-
tural faculties, aridity, and wasting of the body, whicn becomes dried and
parched like a tree deprived of its juices by exposure to excessive heat.
According to Haly Abbas, Hectic Fevers commonly arise, either from the
i^onversion of Semi-tertians, or from abscesses of the lungs, whence heat is
^ent to the heart, and from it is diffused over the system. Theor, viii. 7.
•A^lsaharavius states, that Hectic Fevers arise firom protracted Ephemeral ot
Putrid Fevers, or from sympathy of the system with ulceration of the Lungs,
bladder, or Liver, or from any chronic and prolonged disease. Tract. xxxtL
A.verrhoes represents the Hectic as supervening upon Ephemeral and Putrid
202 GOMMBNTART ON THB 8BC0ND BOOK.
Fevers. He ridicules the comparison of the effects of food on the Febrile
Heat to those of water poured upon lime. Colliget. iv. 33. Avenzoar
gives the same account of Hectic as our author. Lib. iii. tr. 3. c. 13.
Serapion*s account, although borrowed from the Greeks, is distinct and
curious. Tr. vi. 11. — See also Rhases, ad Maruor, x. 3, alihique. He and
Haly Abbas repeat the graphic delineation of a person in the last stage of
Hectic Fever, borrowed by our author from Galen, who seems to have had
in view a similar description of a person sinking of consumption, given by
Aretaeus. De Morb, Chon. i. 8. Avicenna*s account of the nature and
causes of Hectic Fevers is so ample, that I regret my limits will not permit
me to do justice to it. The principal causes of them which he enumerates
are Ephemeral and Putrid Fevers, and abscesses of the Lungs and Liver.
The pulse, he says, is hard, small, frequent, and weak, and may become
myurusy if the fever pass into the state of marasmus. He gives principally
from Galen (de Marasmo) an interesting description of what he calls the
Hectic of old age, but which Galen calls old age from disease. Its symp-
toms, as described by these authors, are coldness and aridity of the body ;
the pulse slow, small, and rare, unless very weak ; the urine white, thin,
and watery. Lib. iv. fen. 1. tr. 3. Frauciscus de Pedemontio, a writer of
the fourteenth century, in like manner pronounces the Hectic of old age
to be a dry intemperament of the system, and recommends to treat it with
a cale&cicnt and moistening regimen.
XXXin. ON THB CURB OF HBCTIC FEVERS.
This chapter is taken from Oribasius, Synop. vi. 22. It will be remarked,
that our author's treatment consists of diluents and refrigerants internally,
with cold applications and baths. It is entirely derived from Galen. Galen
defends, in very strong terms, the use of the cold bath, which had been con-
demned by a celebrated physician of the name of Philip. Meth, Med, lib.
X. He admits, indeed, that an inflammatory or erysipelatous affection of a
vital organ, and a redundance of crude and putrid humours in the body, may
compel us to abstain from the bath ; but, in all other circumstances of Hectic
Fever, he insists that it is the remedium unicum. He also recommends cold
drink and cold applications to the part primarily affected. He speaks ^-
vourably also of the internal administration of renigerants, such as lettuces,
which may also be applied externally. De Marasmo, For diet, he recom-
mends articles of a diluent and cooling nature, such as ptisan, bread steeped
in cold water, and the milk of asses. Meth, Med, u, s,
Aetius, in like manner, recommends the bath, unless the use of it be con-
traindicated by the inflammation of some vital organ, or a fever enkindled
by the putrescency of the humours. He gives minute directions for the ap-
plication of the bath, the amount of which is this, that, under certain circum-
stances, it will be most prudent to use the tepid bath before the cold. In
all cases, he directs to rub the body with oil before going into the bath, and
to get it gently rubbed with towels after coming out of it. He greatly praises
the milk of asses, which he recommends to be drunk warm.
Alexander also forbids the use of the bath, when inflammation of any vital
part is present. He approves greatly of the milk of asses for food. He al-
lows wine only when the patient is of a cold and dry intemperament. I need
not go over the practice of the subsequent Greek authors, as they follow
servilely the doctrines of Galen.
According to Avicenna, the great indications of cure are dilution and re-
frigeration. To the class of refrigerant remedies, he refers barley wat^, the
milk of asses, and trochisks of camphor, with cooling epithemes and ointments.
COMMSNTART ON THX SECOND BOOK. 203
To the class of diluents he refers the bath, about the administration of which
he is Tcry particular. He directs to use ihe tepid bath at first, and gradually
bring the patient to bear the cold. When it can be borne, he says, the cold
bath should be taken immediately after the hot. He also speaks favourably
of the afiusion of tepid water. (The late Dr. Currie of Liverpool found, thai
the tepid afifusion mitigated the paroxysms of Hectic Fever. )--~See Avicenna,
lib. iv. fen. 1. tr. 3.
Haly Abbas directs, when the symptoms of consumption are fairly set in,
to administer before sun-rise trochisks containing camphor, poppies, &c. to
mitigate the cough. like most of the other authorities, he speaks favour-
ably of the milk of asses and of women for food. But, upon the whole,
his greatest dependence seems to have been upon camphor. Tr, iii. 26.
Alsaharavius directs, first to make the patient go into the warm bath,
and immediately afterwards to plunge him into the cold. Pract. tr.
xixii.
What Avenzoar most particularly recommends is the tepid bath of fresh
water, which he directs to be taken several times in the day. He speaks &-
vourably of goat*s milk. Lib. iii. tr. 1. c. 13.
Averrhoes recommends nearly the same practice; but he says that the
bath ought to be gradually applied. He approves of the milk of women,
asses, and goats, and also of refrigerant herbs. Colliget, vii. 15.
Serapion is very minute in his directions about the asses' milk. He says,
the animals should be fed upon juicy and cooling herbs, such as grow by the
side of rivers. He also directs to medicate the bath, by previously boiling-
in it refrigerant herbs, such as gourds, barley, and violets. Tr. vi. 11.
Khases* directions, although they possess, perhaps, little originality, are in
the highest degree interesting. He recommends for food fishes, cooling
herbs, such as mallows, lettuces, citrons, cucumbers, &c. and the milk of
asses or of goats. He especially commends the tepid bath, and directs to .
rub with oil afterwards. He also speaks of applying to the chest cloths
soaked in rose-water which has been cooled in snow. When these cold ap-
plications bring on shivering, he directs to have them somewhat warmed.
He forbids copious draughts of cold water. He recommends cool and
humid air, and cautions to 'avoid smoke. When the belly is constipated, he
<iirects to give opening medicines, such as prunes and manna. When, on
the other hand, the belly is loose, he recommends astringents. He particu-
larly commends trochisks of camphor, which, he says, will cool the heat of
the heart, liver, or chest. Ad Mansor, x. 3. — See also Ckmtin. lib. xxxi.
In the latter work, he informs us, that physicians were divided in opinion re-
garding the use of the bath in Hectic Fever. He forbids the cold bath and
cold drink, when the patient is much wasted, because the cold penetrates to
the vital organs and impairs them.
Baccius, the great modem authority on the use of the bath, strongly in-
sists, that in Hectic Fever it is indispensably necessary that the patient go
first into the warm bath, and then immediately after into the cold. This ac-
cords exactly with the rules laid down by Galen and the best of the ancient
authorities. De Themiis, lib. vii. c. 22. Platearius, Rogerins, and other of
the earlier modem authors, make mention of the bath for the cure of Hectic
Fever. Barzizius directs not to remain long in the bath, and to drink asses'
milk afterwards. De Balneis, p. 225.
XXXIV. — ON THB SEMI-TBRTIAN8.
The reader may find histories of the Semi-tertian in the Epidemics of
Hippocrates, where see the Commentary of Galen. Our author's account
204 COMIIBNTART ON THK SECOND BOOK.
is condensed from Galen, de Diff, Febr. ii. 2. and de Typisy c. 4.— ^See
AetiuSy V. 81. — Actuarius, Morb. l)ig, ii. 1. — Nonnus, c. 142. — Celsus, iii.
8. — Palladius, c. 21. Ceisus describes it as the second species of Tertian in
the following terms : — *' Alterum longe pemiciosius, quod tertio quidem die
revertitur, ex octo autem et quadraginta horis fere sex et triginta per ao-
cessionem occupat, interdum etiam vel minus, vel plus ; neque ex toto in
remissione desistit, sed tantum levius est. Id genus plerique medici
^furpiraiov appellant.'' He approves of bleeding at the commencement and
of a diet that is nutritive without being heating.
Palladius says, that the Semi-tertian is compounded of a Tertian inteiw
mittent and a continual Quotidian, the Quotidian paroxysm taking place
every day, and the Tertian every alternate day. He ascribes their origin to
a mixture of putrid bile and phlegm. C. 21. Haly Abbas gives a similar
account of it He calls it a Fever compounded of a Tertian and Quotidian,
and remarks that it has a tendency to pass into Hectic. He treats it with
diluents and refrigerants. Fract, iii, 17. Avicenna gives a very detailed
account of the symptoms and cure of the Semi-tertians. He remarks that
the Fever is apt to be protracted and to pass into the Hectic. Lib. iv. fen.
1 . tr. 4. — See Khases, ContinenSy lib. xxxi. All his authorities agree in
describing it as a compound of the Tertian and Quotidian, having a severe
paroxysm the one day and a slighter the following. It is said to be gene-
rally protracted to the fortieth day.
Platearius, and the other earlier modem writers, describe the Semi-tertian
in nearly the same terms as the ancients. They in general recommend bleed-
ing for Uie cure of it. The Semi-tertian is minutely described by Mr. Cl^-
horn, (Diseases of Minorcay chap, iii.) and by Hoffman, (Oper. t. ii. §. 1 . c.
5.) The latter does not in general recommend venesection, and trusts prin-
cipally to gentle purgatives and diaphoretics.
XXXV. — ON EPIDEMIC DISEASES.
This chapter is mostly taken from Oribasius, Sj/nops, vi. 24. and Euporist.
c. 1.
The works of Hippocrates contain many interesting remarks on the origin
and nature of Epidemics. He states that diseases in general may be said
to arise either from the food we eat or the air we breathe. When, therefore,
a disease seizes on a multitude of persons of different ages, sexes, and habits,
he justly infers that it must arise from the latter cause. See de FUttibta^
Epidem. cum Commentariis Galeni, It is reported of Hippocrates, that, like.
Acron of Agrigentum, he changed the morbific state ot the atmosphere at
Athens by kindling fires. (Galenus, Therap. ad Fison. — Aetius, v. 94.) — •
Acron*s method of purifying the atmosphere is mentioned by Plutarch, de
hide et Osiride. For an account of Acron, see Fabricii Biblioth, Grac.
tr. xiii. p. 32. — Conringii Introduct, and Mangeti BibL Med, Pliny says
of Fire as a corrective of the state of the atmosphere — '' Est et ipsis ignibos
medica vis. Pestilentiae, qus solis obscuratione contrahitur, ignis suffitu
multiformiter auxiliari certum est. Empedocles et Hippocrates id demon-
stravere diversis locis.'' H. N. xxxvi. 69. With the same intention, Simeon
Seth proposes fumigations with frankincense. The historian, Herodian, re-
lates, that fumigations with aromatics were recommended as a preventive of
the Plague. Lib. i. The merits of the Hippocratic method of purification are
amply and candidly discussed by Van Swieten. — Comment, in Boerh.Aph,
§ 1407. Paulinus properly directs to regulate it by the season of the year
and other circumstances. Fralect. Marc. p. 393. It did not answer in the
Plague of London, A.D. 1666.
COMMBNTART ON THE SKCONB BOOK. 205
Galen, in like manner, attributes the origin of Epidemics to the state of
the atmosphere in a great measure, but also holds that the nature of the
country may contribute ; as, for example, its vicinity to a gulf like the Cha»
ronian, from which miasmata are exhaled that taint the air and occasion dis-
eases. In many passages of his Commentary on the Epidemics of Hippo-
crates, be states that Epidemical diseases arise from the condition ot the
country in which they prevail. It will be recollected that our Sydenham
advanced a similar doctrine. He says, *' And thus it happens, that there
are many constitutions of years that arise neither from heat nor cold, nor
moisture nor drought, but proceed from a secret and inexplicable alteration
in the bowels of the earth, whereby the air is contaminated with such effluvia
as dispose bodies to this or that disease as long as the constitution prevails,
which, at length, in a certain space of time, withdraws and gives way to an-
other." This theory, although I have seen it much ridiculed of late, seems to
me very plausible. The philosophical poet, Lucretius, accounts for the pre-
valence of Epidemical diseases upon similar prrociples : —
'' Atqne ea vis omnis morbomm, pestilitasque,
Aat extrinsicus, at nubes nebulseque supeme
Per codtun veniunt, aut ipsft sspe coorta
I Dtf terrd gurmmtt nbi potrorem htunida nacta est,
IntempestiviB pluviisque, et solibos icta."
DeRerum Natvra, Lib. vl. 1100.
Syllius Italicus appears to refer an Epidemical Fever to the same cause.
Lib. xiv.
If we reject this theory of the origin of Epidemics, I do not see how we
can account for the Malarious prevailing in certain districts of Italy, nay, iii
Certain streets of the city of Rome, while the surrounding country is wholly
exempt from its ravages. But we must return to our exposition of the doc-
trines of Galen. In his work on the Varieties of Fever ^ he expresses his opi-
nions on this subject very fully. He remarks, that an atmosphere of a hot
constitution, such as generally prevails at the time of the rising of the Dog-
star, having been inhaled by the heart, increases the heat in it, from which it
is diffused all over the system, and enkindles a Febrile affection. lu pesti-
lential constitutions, he adds, it is principally by the respiration that the dis-
ease is contracted, although sometimes it may arise from the fluids of the
body being disposed to putrescency, which is increased by the condition of
the atmosphere ; but for the most part Epidemical complaints derive their
origin from the atmosphere being tainted with putrid exhalations. The pu-
tridity of the atmosphere may be occasioned either by a multitude of dead
bodies which have not been burnt, as is apt to happen in wars, or it may
^rise from the exhalations of certain marshes or lakes in the summer season,
or sometimes the inordinate heat of the atmosphere may give rise to them, as
bappened in the case of the Athenian plague, according to the testimony of
"Thucydides. And here again I must digress to remark, that Homer evidently
Ascribes the plague which attacked the Grecian army to the great heat of the
sun. — (See the Commentary of Eustathius on the beginning of the Iliad, Am-
mianus Marcellinus, lib. xix., Heraclides Ponticus, Allegor., and Macrobius,
Sutumaliay vii. 5.) Galen, however, inculcates that the constitution of the
atmosphere alone is not sufficient to produce disease without a peculiar dis-
position of the body to admit it ; for that, otherwise, all without exception
^would be seized with the prevailing epidemic. This leads him to give di-
rections to correct the intemperament of the body when it is such as disposes
it to be readily affected by the constitution of the atmosphere. His directions
^re similar to those of our author. Besides tlie causes of Epidemical dis-
eases which we have mentioned, he states that unwholesome food and drink
may sometimes, though rarely, give rise to them. Of this he relates a striking
206 COMMENTARY ON THE SECOND BOOK.
instance. De Rebu$ Boni et Mali Succi^ c, 1. He remarks, that the most com-
mon Epidemical diseases are Pestilential Fevers. We shall have occasion
to state his opinion of them in the next chapter.
Of the Greek authors posterior to Galen, Oribasius and Aetius give tlie
same account!of Epidemical diseases as our author ; and the others either do
not treat of them at all, or class them with the subject of our next chapter.
Avenzoar has given us a separate treatise on Epidemical complaints. The
first cause of them which he mentions is a humid and warm state of the at-
mosphere, such as that to which Hippocrates ascribed the Pestilence which
afflicted Thason in his time. {Epidem, iii.) The other causes enumerated by
him are, the effluvia from dead bodies, stagnant air, the miasmata from stag-
nant and corrupted waters, and unwholesome food. Lib. iii. tr. 3. c. 1.
On the origin of Epidemical diseases, especially the Pestilence, see, in par-
ticular, Haly Abbas, Theor. v. 1 1 . The principal causes of the change of the
atmosphere to a pestilential state, according to Haly, are the nature of the
country and the season of the year. The former cause operates owing to the
putrid effluvia arising from corrupted fruit, pot-herbs, &c. or the miasmata
from marshes, cloacs, or dead bodies, whether of men or cattle. It was from
such causes, he remarks, that the Plague of Athens derived its origin. The
nature of the season, as it produces diseases in the vegetable, so does it also
in the animal creation. As Epidemical complaints, he mentions Ephemerals,
Cynanche, Small-pox, Acute Fevers, and other fatal diseases.
Avicenna's account of the origin of Pestilential and Epidemic diseases is
taken almost entirely from Galen ; he therefore enumerates as causes of them
a humid and warm state of the atmosphere, the stagnant air of caverns, the
miasmata of lakes and marshes, and the effluvia from dead bodies. Lib. iv.
fen.i.tr.4. Alsaharavius enumerates exactly the same causes. Tr. 32. Rhases'
account is mostly taken from Hippocrates and Galen. Contin, lib. xxx.
The Latin historian, Ammianus Marcellinus, gives an ingenious disquisi-
tion on the origin of these diseases ; but the distinction which he endeavours
to establish in the following passage is not acknowledged by the medical
authors in general : — << Prima species luis Pandemus appellatur, quae efficit
in aridioribus locis agentes caloribus crebris interpellari ; secunda, Epidemus,
quee tempore ingruens acies hebetat luminum, et concitat periculosos humores ;
tertia, Lamodes, quae itidem temporaria est, sed volucri velocitate letabilis.'' —
Lib. xix. c. 4. The causes of these complaints, as enumerated by him, are,
excessive heat, cold, drought, or moisture, effluvia from putrid bodies, and
exhalations from the earth.
According to Diodorus Siculus, the causes which gave rise to the Pesti-
lential Epidemic which attacked the Carthaginian army in Sicily were, the
marshy nature of the country in which they were encamped, the bodies of
the dead lying unburied, and the excessive heat of the season. Lib. xiv. He
ascribes the Plague of Athens to similar causes. Lib. xii. 58.
XXXVL ON THE PLAGUE.
By the Plague, as Galen explains, in his Commentary on Hippocrates, is
to be understood an Epidemical Fever of a fatal nature. Hippocrates has
related several histories of diseases which come under this description, in his
Epideviics, but they present such variety of symptoms, that I cannot under*
take to give their general characters. I shall, therefore, begin my exposi-
tion of the ancient opinions regarding the Plague, with a brief notice of the
celebrated description of it given by Thucydides, the Greek historian, with
which the cases related by Hippocrates agree very well on the main. The
more prominent symptoms mentioned by him are the following : — Strong
COMMENTARY ON THB SECOND BOOK. 207
beat of the head, redness and inflammation of the eyes ; the mouth and inter-
nal fauces turgid with blood, breath fetid ; sneezing, hoarseness, and after-
wards violent cough, vomiting of bile, singultus, and convulsions ; the heat
of skin not much increased, but the internal parts glowing with heat; the
skin reddish, or livid, and covered with minute phlyctsne and ulcers; de-
spondency, restlessness, and intense thirst ; and, towards the conclusion,
diarrhcea, ulceration of the bowels, and various symptoms of putrefaction.
Those who survived the Febrile attack were subject to blindness, fatuity, ami
mortification of the testicles and extremities. The disease generally proved
fdiaX on the ninth or seventh day. The historian affirms that the plague never
attacked the same penon more than once. This opinion has been advocated
in modem times by Massarius, Diomedes Amicus, Heumius, and Sir Wil-
liam Pym, but general experience seems to be against it. Evagrius relates
of the plague which prevailed in the reign of Justinian, that many persons
who recovered from the first attack sunk under a second. Ficinus, Montisi-
anus, Joubertus, and many late authorities, hold this opinion. Thucydides'
celebrated description of the Plague is given in a poetical form by Lucretius,
de Remm Natwa, apudfineniy and by Ovid, Metamorphoseon lib. vii. 1.528.
Sophocles, the tragedian, appears also to have had it in view. Oedip, Tyram,
ap. initium. The Latin poet, Silius Italicus, evidently copies his images from
it. Lib. xiv. See also Lucanus, Fhartul. lib. vi. and Manilius, A$tronom,
lib. i.
Our next great authority on this subject is Celsus. In his account of the
Plague, weJiave to regret however, that, although he dwells rather minutely on
the Prophylaxis and Treatment, he has omitted to give us a description of the
disease; and it is not easy to perceive the principles upon which some of
his directions as to the Prophylaxis are given. He recommends a journey to
a distant place, or a sea voyage; when this cannot be accomplished, gesta-
tion and gentle exercise in the open air, but he forbids all excess. He also
Ibrbids early rising, exercise with naked feet after a meal or the bath, also
emetics, laxatives, and sudorifics. He directs to drink, by turns, first water
stnd then wine. Lib. i. c. 10. It would appear to have been his wish that all
depletion should be avoided, lest, by emptying the vessels, absorption should
be accelerated. With regard to the Treatment, he disapproves, in general, of
abstinence and purgative medicines, recommends bleeding, if the strength
permit, more especially if the Fever be attended with pain ; but, if veneseo-
lion cannot be practised, he directs to give Emetics. At an earlier period
than in ordinary £evers, the patient is to be put into the bath, and is after-
^vards to get hot undiluted wine, and every thing of a glutinous nature, and
flesh of this description. In the case of young persons, he directs to admi-
nister these remedies with great caution. Lib. iii. c. 7.
The historian Appian, Lucian, and Plutarch, mention wine as an antidote
to the Plague. Livy and other ancient writers say that the Plague is some-
times occasioned by excessive cold. Histor. lib. v.
It is greatly to be regretted that Galen has given us no description of the
dreadful Plague which prevailed in his time. It appears that he fled from
Home for fear of infection. lie alludes to it, indeed, in several parts of his
works, but in very brief terras, only mentioning that it put on the appear-
ance of Dysentery ; and in one place he strongly commends the celebrated
Tberiac as a most efficacious remedy for the prevention and cure of Pestilen-
tial disorders. Of the writers on medicine posterior to him, Oribasius and
Aetius, like our author, give no further information on this important subject
than what is contained in the brief extract from the works of Ruffus ; — and
the others, with the exception of Nonnus and Psellus, do not treat of the dis-
ease at all, unless in an incidental manner. Nonnus, after briefly stating the
causes of the Plague, proceeds to lay down the principles for conducting the
208 COMMENTARY ON THB SBCONO BOOK.
treatment. He recommends clysters, and, if the stomach be loaded wHh
phlegm, emetics : if there be a fulness of blood, he approves of venesection ;
and also speaks well of giving diuretics. When symptoms of ardent fever
are present, he directs to give cold drink freely, in order to extinguish the
Febrile heat. He also recommends apomel, the water of ptisan with the seed
of bastard saffron, or Armenian bole, or lapis lazuli. Psellus merely men-
tions, in very general terms, a few of the common symptoms of the Plague.
Opus Medicum.
Before proceeding to the Arabian authorities, I shall give a brief ab-
stract of Procopius* description of the dreadful Plague which desolated the
Roman Empire in the reign of Justinian. Its usual precursors were certain
delirious phantasies and disturbed dreams, after which the fever made its at-
tack suddenly. The early symptoms, however, ware not well marked, for
there was neither increased heat nor discoloration of the skin, nor did the pa-
tient apprehend danger. Generally on the first or second day, but in a tevr
instances somewhat later, buboes appeared not only in the groin but also in
the arm-pits and below the ears. S<Ane were affected with deep coma, and
others with wild delirium. Some died from sphacelus of the buboes, which,
when inspected by the physicians after death, presented the appearance of a
coal or carbuncle (anthrax.) Some died at the commencement, and others
after the lapse of several days. In certain cases the skin was covered over
with black phiyctaenae of the size of a lentil, which were usually succeeded by
sudden death. Others were unexpectedly cut off by a discharge of blood.
To women in the puerperal state it proved particularly fatal. When the
buboes came to a proper suppuration, they generally proved a favourable
crisis, but when they did not suppurate they were commonly followed by a
wasting of the thigh. One of the common consequences of the fever was an
affection of the organs of speech. All the usual prognostics proved fallacious,
and the effects of the common remedies were uncertain. In some cases the
bath proved beneficial, and in others it had a contrary effect. At one time
the amount of deaths in Constantinople ranged from five to ten thousand each
day. This Pestilence is described likewise by Agathias, lib. v. and by £va-
grius. It resembled the Plague of Avignon, described by Guy of Cauliac.
The symptoms of the plague, as enumerated by Avicenna, are as follows: —
Heat, and strong inflammation within, but which are not perceived out-
wardly; respiration large, fetid, and frequent, intense thirst, dryness of the
tongue, with nausea and loss of appetite, such as if not contended against
will prove fatal ; enlarged spleen, great anxiety and restlessness, dry cough,
prostration of the powers approaching to syncope; delirium, retraction of
the hypochondria, insoranolency, with tepid heat of the body. Sometimes
there are yellow, whitish, or red eruptions on the skin which are of short
continuance ; or else aphthae and ulcers in the mouth. The pulse is gene^
rally frequent, small, and becomes stronger towards night. Occasionally
there are dropsical swellings. The discharges from the bowels are bilious,
mixed, fetid, unnatural, and sometimes contain black bile; at other times they
are frothy and fetid, or unctuous, being produced by melting of the fat. The
urine is watery, bilious, and melanchulic. There is sometimes vomiting of
black, but more frequently, of yellow bile. There are often fetid sweats.
The disease usually terminates with syncope, coldness of the extremities,
lethargy, spasms and convulsions. Some of the most fatal varieties of the
plague are not marked by any striking symptoms, neither the heat, pulse, nor
urme being much affected. Fetid breath, as indicating putrefaction about
the heart, is a most mortal symptom. The treatment must commence with ve-
nesection, if there be a plethora of blood, or with purging, if the body be loaded
with other humours. The apartments of the sick are to be cooled, and the
air of them corrected : they are to be cooled by cold odoriferous fruits,
COMMBNTAKT ON THE 8BC0NO BOOK. 209
camphor, rose-water, or, if possible, by introducing a stream of water into
them. The fetid air may be corrected by fumigations with camphor, myrtles,
quinces, ebony, &c. by sprinkling the apartments with vinegar and assa-
fcetida, and correcting the putridity with lignum aloes, frankincense, musk,
storax, sandarach, mastich, juniper, bays, and the like. (It may be proper to
mention, that arsenical fumigations are approved of by Muratori, Lind, and
Russel, but Condemned by Mead.) As a preservative from the Plague, he
recommends, in particular, exercise and restricted diet, llaly evidently
copies liis description. Theor. v. 1 1 .
kluises agrees with Hippocrates in stating, that Pestilential Fevers are dis-
tinguished by great heat internally, while the surface of the body is cool.
The symptoms, as detailed by him, are, vomiting and diarrhoea, pain and
distension of the belly, coldness of the extremities, urine showing a tendency
to putrefaction, discharge of blood from the nose, heat about the breast,
singultus tendinum, blackness of the tongue, bulimia, &c. He particularly
states, that a black discharge from the bowels is a most fatal symptom. Like
Avicenna, he gives directions to perform fumigations with camphor, musk,
myrrh, bdellium, frankincense, and the like. He mentions that, dur-
ing the prevalence of a certain pestilence, it was found that hunters escaped
the contagion. Like Avicenna, he approves of blood-letting — (See Continetvt,
lib. XXX.) He also recommends cold drink and the cold bath. Calefacients
and wine, unless diluted with much cold water, he disapproves of. Ad MaU'
ior, iv. 25.
While explaining the symptoms and treatment of the Plague, as detailed
in the works of the ancient authors, I have purposely omitted to notice its
contagious nature, as I wished to give one connected view of the ancient
opinions regarding Contagiok. Before entering upon this disquisition, I
think it proper to acknowledge the assistance which I have derived from the
writings of Fracastorius, Paulinus, Mead, Marx, Omodei, and Winterbottom,
leaving it to the reader to determine, after comparing my humble attempt
with their learned labours, whether or not my industry and research have
contributed in any wise to throw additional light upon this important sub-
ject.
The earlier ancient authors appear to have entertained no suspicions of
Contagion as a cause of Febrile, or of other complaints. Homer, as formerly
stated, evidently refers the origin of the Plague which prevailed in Uie
Grecian army during the siege of Troy to the heat of the sun. The works
of the Fathers of History and of Medicine have likewise been ransacked in
vain, for any traces of the doctrine of Contagion. Tfmcydides, therefore,
appears to be the first author (if we except the Mosaic description of Leprosy)
yi\io makes any positive allusion to the contagious nature of diseases. From
his description of the Plague of Athens, there can be no doubt that he
wishes it to be understood, that the disease was transmitted from one person
to another ; for he mentions that physicians were more attacked by it than
any others, as having most intercourse with tlie sick ; and he afterwards
describes the terror which the citizens felt to approach those labouring under
the disease, and intimates that it was often contracted by such intercourse^
The language of Lucretius, who copies his description, and gives it a poetical
form, is still more precise : —
li
nullo cessabant tempore apisc
Ex aliis alios avid! contagia morbi.'*
L. 1236.
And afterwards, —
*' Qui fderant autem prsesto contagibus ibant.**
L. 1241.
210 COMMSNTART ON TH8 SECOND BOOX«
Ovid, in like manner, says of the dead bodies :-«
** Afflatuque nocent et agont oontagia latd."
Metam, lib. y. 551.
And so also, Silius Italicus : —
<* Et posnere avidae mortis contagia pestes."
lAb. xiy.
The historians we must dismiss in a few words, with stating that allusions
to the infectious nature of certain diseases are to be met with in Livy, Dio-
nysius the Ualicamassian, Diodorus Siculus, Appiao, Plutarch, Qnintus
Curtius, Dio Cassius, Eusebius, Gregory of Nyssa, and Evagrius. Procopius
was a non-contagionist.
The philosopher Aristotle, in one of his Problems, makes it a question
why the Plague is the only disease which infects those who approach the
sick. Probl. §. 1 . The Elder Pliny mentions the contagion of the Pesti-
lence.
Virgil mentions the infectious nature of certain diseases of cattle. Eel. i.
Georg, iii. 464. The ancient writers on Veterinary Surgery and Agricul-
ture, in like manner state that the Plague and Scabies m cattle are infec-
tious.— See Columella, vi. 5. Vegetius, Mulomed. iii. 23.
The philosopher Marcus Antoninus, alludes to the Plague as being con-
tagious. Lib. ix. §. 2. Chrysostom does the same. In Joan, Orat, Itii.
The language of Seneca is very precise : — " Itaque ut in pestilentid, caven-
dum est ne corruptis jam corporibus et morbo flagrantibus assideamus, quia
pericula trahemus, afflatuque ipso laborabimus." — De Tranquil, c. vii. To
these we may join Isidorus Hispalensis, a much later writer : — *^ Pestilen-
tia est contagium quOd quum unum apprehenderit celeriter ad plures
transit.'' And, in another place : — '* Pestilentia est morbus latb vagans et
contagio suo quae contigerit interimens.'' — ^Alexander Aphrodisieus intimates
that Pestilential Fevers are contagious, but Common Fevers not so. ProbL
ii. 42.
Aretseus appears to be the first medical author who alludes to Contagion in
unequivocal terms. He says of Elephantiasis, that it is as infectious as the
Plague, being communicated by respiration. Coelius Aurelianus, who was
probably nearly cotemporary with him, mentions as contagious diseases the
Plague, Incubus, Hydrophobia, and Elephantiasis. Gralen expresses his
sentiments on the Contagious nature of certain diseases in the following
terms ; — " That a Pestilential state of the atmosphere produces Fever, is un-
known to no one possessed of good understanding ; and, also, that it is
dangerous to associate with persons having the Plague, for there is a risk
of catching it, like the Itch and Ophthalmy. It is dangerous also to live
with those labouring under Consumption, and, in a word, with all those hav-
ing a putrid respiration of such a nature as to render the houses in which they
lie fetid.*' De Diff, Febr. i. 3. — Aetius (lib. xiii. 120.), and our author
(lib. iv. i.) state their decided opinion of the infectious nature of the Plague
and Elephantiasis. Oribasius, Alexander, Synesius, Palladius, Actuarius,
and all the Latin Medical authors, with the exception of Coelius Aurelianus,
have omitted to make any allusion to the Contagious nature of diseases.
Of the Arabians, Khases mentions, as diseases " which are transmitted
from one person to another,'' Lepra (Elephantiasis ?), Itch, Consumption,
and Pestilential Fever. These, he says, prove infectious, when one is shut
up in a narrow house along with those labouring under them, or when one
sits in the wind blowing from them. He states afterwards, that Ophthalmy
and malignant Pustules are sometimes contagious. Ad Mansor. iv. 24. —
See also Contin. lib. xxxiii. tr. 5. By malignant Pustules he means the
COMMENT ART ON THK 8BC0ND BOOK. 211
Small Pox. Avicenoa and Haly Abbas give the same list of Contagious
diseases. Avicenna says that Small Pox and Measles are 'of all diseases the
most contagious. Of the other Arabians, Avenzoar alone, while treating of
Elephantiasis, alludes to the doctrine of Contagion.
naving now done with the ancient authorities, I shall only give further
the declaration of the celebrated Boccacio regaixling the Plague of Florence :
— '* £ fu questa pestilenza di maggior forza, percio che essa dagF infermi di
quella per io communicare insieme s' avventava a' sani non altramenti che
faccia il fuoco alle cose secclie o unte, quando molto gli sono avvicinate.*'—
Decameron^ Introduzione,
The result of my investigations into the opinions of the ancients on this
subject leads me to the conclusion, that all, or at least the most intelligent
of the medical authorities, held that the Plague is communicated, not by any
specific virus, but in consequence of the atmosphere around the sick being
contaminated with pntrid effluvia. Hence, they maintained, that mild
fevers (jTvmjB^is) which show no tendency to putrescency, are not communi*
cable from one person to another. — (See Alexander Aphrodisieus, u. s.) It
would appear, therefore, that their sentiments agreed pretty much with those of
the more moderate Macleanites of the present day, who admit that the Plague
is Contaminative, allthough not, properly speaking, Contagious. — (See Tkc
Westmimter Remewy No. vi. Art. 10.) Fracastorius, in like manner, consi-
dered putrefaction as the source of all Contagion (X)e Contag. lib. i.); and
nearly the same opinion was maintained by the learned Fernel, and Fran-
ciscus de Pedemont, Ingrassias, Ficinus, and others. V. Fralect. Mar, p.
77. Although Galen several times speaks of a poison being formed in the
human body, he means that the animal fluids are so altered as to become
deleterioos, and does not bold that there is any specific virus transmitted
iirom one person to another. De Lac. Affect* v. 7. vi. 5. Epidcm, iii.
Cent. r.
XXXVII. ON FEYSRS COMPLICATED WITH SYNCOPE OCCASIONED
BY THICK HUMOURS.
This chapter is taken either from Oribasius, Sj/nop. vi. 27, or Aetius, v.
97. These authors, however, merely abridge the account of this subject
which is g^ven by Galen. Meth. Med. xii. 5, and Therap. ad Glauc. lib, i.
Syncope, according to the explanation of Galen, is a sudden prostration of the
vital powers, without suspension of the respiration, as in deliquium animu
Our author has given a very correct account of Galen's treatment. He states
that, the system labouring under a load, the great indication is evacuation,
but that venesection cannot be borne in such cases. In short, he insists
that our great dependence must be placed on friction, for the application
of whidi he gives very excellent directions. When the pulse suddenly sinks
and becomes irregular, he directs to administer wine, unless there be inflam-
mation of the stomach or liver. In cases complicated with crude humours,
he pronounces the bath to be most prejudicial, and also disapproves of very
cold or very warm air. He is most particular in his directions for the selec-
tion of the most proper wine to be used, and gives some interesting observa-
tions on the principal Greek and Roman wines used in his time. He con-
cludes his remarks with stating that thick wines ought to be avoided as in-
jurious, and such as are watery and thin, as ineflectual, whereas those of a
middling kind are to be selected. He particularly praises the Arvisian and the
Lesbian. The Falemian he condemns, as being too fragrant and austere,
vrhich qualities render it injurious to the head.
Alexander disagrees with Galen as to several of the points of treatment
p2
212 COMMBNTART ON THE SBCOND BOOK.
laid down by him. He insists that Galen*s rigid rules for applying strong
friction, at the same time that abstinence is enjoined, are such as no ordinary
powers of constitution could bear up under; and, therefore, he recommends
to rub first, and then to give some light nourishment, such as thin ptisan,
oxymel, and bread soaked in wine, when the strength is greatly overpowered.
Nay, when the powers of the constitution are in danger of sinking under the
weight of the load, he suggests the propriety of having recourse to venesec-
tion ; and accounts for the benefit derived from this evacuation, upon the
same principle that a fire which is like to be extinguished by an excessive
load of green fiiel burns brighter when part is taken off. This is an in-
genious explanation of the manner in which bleeding proves useful in cases
of Congestive Fevers. Respecting the use of wine and the bath, his views are
similar to those of Galen. He approves very much of administering a light-
coloured diffusible wine, when the powers of the system ai*e much sunk.
Avicenna adheres closely to the principles of treatment laid down by
Galen ; and, therefore, says nothing of venesection. Lib. iv. fen. 1 . tr. 2l
c. 58. Rhases treats this complication of Fever in like manner. He calls it
** Febris syncoptica, ex humorum copi& et cruditate nata.'' Ad Mansor, x.
14. He mentions Emetics, but approves most particularly of Friction.-
Continens, lib. xxx.
Averrhoes contends that, in such a case, it is lawful for a Mussulman to
drink wine, although forbidden by the Prophet. He approves also of Fric-
tion. CoUiget. vii. 16.
Prosper Alpinus informs us that the Methodists, in such cases, gave wine
and aromatics, and used every means to rouse the system. Med, Method,
vi. 9.
Dr. Robert Jackson describes a variety of Fever occurring in warm
climates, which appears to have been very similar to the Febrile state treated
of in this chapter. He represents it as being distinguished by a particular
dullness, sluggishness, obscure weak pulse, nausea, and deep respiration.
Like Alexander, he approves of bleeding, which he directs to be performed
with the extremities immersed in hot water ; and they are afterwards to be
scrubbed with stimulant applications. — On Fever , p. 193. Having too often
had occasion to lament the inefficacy of the treatment usually followed in
such cases, I cannot but think that the plan recommended by Alexander
and Dr. Jackson, is well deserving of a trial.
XXXVIIL ON SYNCOPE PROM THIN HUMOURS.
This is taken from Galen. Meth. Med, xii. 6. — See also Oribasius,
Synop. vi. 27. Aetius, v. 98. In this case, Alexander recommends nearlv
the same plan of treatment as Galen. He recommends for food things which
are incrassant and anti-discutient, such as the juice of halica, succory, let-
tuces, apples, pomegranates, pears, &c. They must be administered, how-
ever, in small quantities. He approves of giving a weak watery wine, not
very old. He recommends friction with tonic and incmssant oils, such as
the oil of apples, and other applications of a like nature.
Avicenna, Averrhoes, and Rhases, treat the case exactly as our author.
XXXIX. ON THE OTHER CAUSES OP SYNCOPE.
See, in like manner, Galen. Meth, Med. xii. 7. — ^Oribasius, Synop, fi.
28.— Aetius, v. 99.
COMMBNTART ON THE 8KC0ND BOOK* 218
XL, — ON PAIN.
This chapter is taken from Oribasius, Synup. vi. 29, or Aetius, v. 100.
All these authors, however, merely abridge the account given by Galen.
Meth, Med, xii. 8, and de Locis Affect, lib. ii. In the latter work, he gives
a most ingenious dissertation on the different kinds of pain, and the states of
the body in which they occur; but, as our author has given a summary of
his observations, I think it unnecessary for me to go over the same ground.
I shall, therefore, merely notice some of his remarks on the treatment, as de-
livered in the other work. When the pain is connected with flatulence, it is
to be removed by food, drink, cataplasms, and fomentations of an attenuant
nature. When pungent humours are the cause of the pain, they are to be
treated by evacuants, diluents, or narcotics. When occasioned by thick and
viscid humours, he forbids to give narcotics, the action of which, being frigo*
rific, renders them thicker, and the containing parts more compact. In all
such cases, therefore, he holds that opium and hyoscyamus, although they
afford a temporary relief from pain, act prejudicially. lie also directs to
avoid things of a very hot nature, both internally and externally, and recom-
mends to give attenuants, or tilings of an incisive nature. He, m particular,
commends Garlic, which he calls the Theriac of rustics. As to external ap^
plications, he directs, in Febrile cases, to use first a dry fomentation of millet
seeds, and, if it is not successful, to apply friction with subtile or attenuant
oils, and the fat of fowls.
Aetius defines pain to be a sensation produced by a sudden change of
temperament, or a solution of continuity. In illustration of the former
cause, he remarks that sUl sudden changes from heat to cold, or vice versa, oc-
casion severe pains. To the latter he refers rupture, contusion, and erosion
of the parts. Kupture is produced by tension, contusion by weight, and
erosion by some pungent quality. These causes of pain ought to be particiH
larly attended to, and the treatment modified accordmgly. His subsequent
account is exactly the same as our author*s.
The different kinds of pain are fully treated of by Avicenna, lib. i. fen.
^- doct. 3. c. 20, and by Ilaly Abbas, TIteor. vi. 16. Averrhoes has de->
^'^ered the treatment of this complication of Fever, in nearly the same
^rms as Galen. When the pain is occasioned by warm air or fiatulence, he
Particularly commends cupping applied with great heat. He agrees witli
^'^len in condemning narcotics, when the exciting cause is of a cold nature.
^e also joins him in condemning hot fomentations and clysters, when the
P^in of the bowels is occasioned by a hot humour. CoUiget, vii. 18. — See
Phases, Cont, xxxiii.
X^or an account of the ancient opinions on this subject, the reader is re-
ferred to Prosper Alpinus, de l^nes. Vita et Morte Ajgrot. lib. ii. 18.
XLI. ON COLLIQUATIVB DIARRU(£A, OR MBLTING.
Galen mentions that a colliquative discharge from the bowels was a cora-
'^^ii symptom of the fatal Plague which prevailed in his time. He adds,
JtJ^t: the faces were generally of a deep yellow colour, and always fietid.
.^^nment, in Hippocrat. Epidem. lib. iii. In another place, he states that
^i^is a fatal practice to bleed or purge in cases of Fever complicated with
^i^rrhcea. Therap, ad Glauc. lib. i.
Our author borrows from Oribasius, Si/nop, vi. 30, or Aetius, v. 91 .
The Arabians direct to treat Febrile melting upon general principles, as
^^^lained under the head of Diarrhoea.
214 COMMENTARY ON THK SBCOND BOOK.
Although cold applications for the Colliquative Diarrhaa of Fever are not
now generally approved of, we are informed by Dr. Robert Jackson, that he
had found them highly beneficial in such cases. — On Fever. — See Book iii.
c. 42.
On the Colliquative Diarrhcea in Fevers — see, further, Prosper Alpinus,
de Pras. Vita et Morte jEgrot. lib. vii. 11, and Fabii Paulini Fralect.
Marc. p. 343.
XLII. ON WATCHFULNS8S IN FEYBRS.
We are informed by Cetsus, that Asclepiades trusted almost entirely to
gentle friction in such cases. Lib. iii. c. 18.
Our author, as usual, copies freely from Oribasius. — See iSywop. vi. 3t.
Nearly the same directions are given by Aetius. Lib. v. c. 116. Those in
the beginning of the chapter are from Galen ; the remaining part is from
Herodotus and Philumenus.
Nonnus gives a correct account of the established rules of treatment m
such cases. Thus, he directs to use ligatures, and apply friction, to the ex-
tremities ; and, if this treatment have not the desired effect, to have recourse
to soporific decoctions, or liniments prepared with poppies, opium, mandra-
gora, &c. or even to give internally an infusion of poppy heads. Epitome^
c. 145.
The directions given by Avicenna are so like oiir author's that we mast
suppose them copied from him. He directs first to try the effect of fatiguing
the patient, by talking loud to him, placing many candles in his chamber,
and applying ligatures to his extremities. When this method does not suc-
ceed, he recommends the soporific applications mentioned by our author.
When there is nothing to forbid the use of it, he permits to give the syrup of
poppies. Lib. iv. fen. i. tr. 2. c. 20. Haly Abbas likewise recommends
poppies externally and internally. Tract, iii. 23. Averrhoes briefly directs
to use food and applications of a soporific nature. Colliget. yi\. 2. Rhases
mentions our author's plan of treatment, and further seems to approve of
liniments made of mandragora, opium, henbane, and the juice of lettuces. —
Cont. lib. xxxi.
Coelius Aurelianus remarks, that the indiscreet use of soporifics may bring
on lethargy. According to Prosper Alpinus, the Methodists approved of fo-
mentations, consisting of soporific medicines, such as lettuces, opium, and
the like. Med. Meth. vi. 8.
Sydenham and Van Swieten agree in condemning the early use of Nar-
cotics.
The earlier of the modem writers on Medicine direct to apply to the nose
a sponge soaked in a soporific liniment prepared from opium, henbane, man-
drake, cicuta, lettuce, and the like. — See Theodoricus, lib. iii. c. 8.
XLIIL — ON CATAPHORA, OR SOMNOLENCT.
The treatment mentioned by our author is recommended by almost all the
other authorities both before and afler his time. — See, in particular, Oribasius,
Syn, vi. 33. — Aetius, v. 117. — Nonnus, Epitome^ c. 146. — Avicenna, lib. iv.
fen. 1. tr. 2. c. 18. — Haly Abbas, Pract. iii. 23.
Prosper Alpinus gives an excellent account of the practice of the Metho-
dists. It consisted of painful friction, tight ligatures, rubefacients applied to
the extremities or head, sternutatories, and, in short, every thing calculated
to rouse. Med. Mcth. vi. 7.
COMMENT ART ON THB SECOND BOOK. 215
Somnolency, or a Coroatous disposition, is a common symptom of Pesti-
lential Fevers. — See Russel on the PlaguCf p. 83, and Assalini, Observatiom
on the Plague, p. 34.
XLIV. ON HEADACH IN FEVERS.
Part of the directions delivered by Celsus for the treatment of headach
deserves to be given in his own language : — ^ Si capitis doiores sunt, rosam
cum aceto miscere oportet, et in id ingerere : deinde habere duo pittacia,-
quse frontis latitudinem longitudiuemque squent : ex his invicem alteram
in aceto et ros& habere, alterum in fronte ; aut intinctam iisdem lanam suo-
cidam imponere. Si acetum offendit pur& rosH uterdum est, si rosa ipsa
Isedit, oleo acerbo.'" If this does not succeed, he directs to use other more
refrigerant applications prepared with iris, poppies, ceruse, litharge, &c. —
Lib. iii. c 10. p. 112. Ed, MUligan.
When headach occurs towards the beginning of Fever, Galen directs to>
bleed once and again, if there be nothing to contra-indicate depletion, and
more especially if the patient be plethoric. He then directs to attend
whether it arise from fumes proceeding from the stomach, or constipa-
tion of the bowelsy and to correct these conditions accordingly. If it make
its attack after the seventh day^ he recommends first to evacuate the bowels
by clysters, then to cup the back part of the head or neck, or to use paregoric
applications, such as rose oil, with some vinegar, if in summer ; but, if in win-
ter, especially in persons of a cold temperament, the oil of camomile, with
a fifth-part of vinegar. — See, further, de Med. sec. Locos, lib. ii.
Aetius likewise recommends bleeding, purging, and vomiting, when not
contrarindicated ; and gives very proper directions about the local applica-
tions. He directs to soak a hand^l of wool in some cooling fluid, and, hold*
ing it above the head, to squeeze out the fluid, so that it may fall upon the
bead from a height. Lib. v. 100.
Palladius says, that headach in Fevers is occasioned by repletion and dis*
tention of the veins, owing to fumes arising from the stomach. De Febribui,
c. 13. Nonnus merely abridges our author's account. Epit. c. 147.
Ayicenna's directions about the local applications are brief, but similar to
those of the Greeks. Lib. iv. fen. i. tr. 2. c. 19. Haly Abbas recommends bleed-
ing and attention to the state of the stomach, for the relief of which he in cer-
tain cases permits the use of wine. Pract. iii. 20. Rhases joins preceding au-
thorities in recommending to pour vinegar and rose oil upon the head. They
are to be used cold in summer, but hot if in winter. — Cont. lib.xxx.
We have seen that Celsus approved of cold and astringent applications to
the head. The Methodists condemned this practice, and recommended to
pour hot water upon the open of the head. Hippocrates seems to allude to
tii^is practice, when he says: '* Much hot water poured upon the head re-
nnoves Fever.'^ Aphor. vii. 42. Prosper Alpinus gives an excellent account
of the Methodical treatment. Med. Meth. ii.6.
It appears to be a proper view of the case which Rogerius takes up,
t^9i.iDely, to foment the head with hot decoctions when the headach is critical,
irt order to encourage evacuation by sweating or bleeding at the nose, and,
if otherwise, to use cold applications. Tr. iii. c. 19.
XLV*— ON THE CARE OP STOMACH AFFECTIONS.
Celsus notices these affections. When there is pain and inflammation
about the prtecordia, he recommends to use at first repellent cataplasms, and.
216 COMMKNTARY ON THB SECOND BOOK.
when the inflammation abates, to exchange these for hot fomentations, where-
by the remains of the complaint will be removed. Pain without inflamma-
tion requires no application, as it will be carried off by the Tever itself. Lib.
iii. c. 10.
Galen treats of all sorts of applications for affections of the stomach in his
work, de Med. sec. Locos, lib. viii. Our author follows Aetius, V. 95.
For atony of the stomach, Alexander recommends the applications men-
tioned by our author. When there is aidor of the stomach, a seasonable
draught of cold water, he says, may do much good, whereas if unseasonably
given it will prove highly dangerous. For atony of the stomach, he also recom-
mends hot wine, if not contra-indicated ; and most especially friction of the
extremities. When it can be borne, the bath, he says, proves beneficial in
cases of atony. When there is a sense of cold, he recommends poppies and
wormwood. When the stomach is loaded with offensive humours, he directs
to give an emetic of oil and water. This remedy, he adds, sometimes ope-
rates downwards with the best effects, and he directs to promote its purga-
tive operation by giving suppositories. He concludes, with recommending
to strengthen the stomach by giving a decoction of wormwood with wine, but
forbids to give this medicine until the Fever be abated. Lib. xii. 3.
Of the Arabian authors, Serapioifs account is the fullest, but it is taken
almost word for word from Alexander, tr. vi. 19. iihases states, that he had
often seen bad consequences arise from evacuation having been practised
before attending to the stomach. Contin. lib.xxv.
XLVL — ON INORDINATE CHILLS AND RIGORS IN FETERS.
«
These Febrile symptoms are treated of by Celsus at considerable length.
Lib. iii. 11, 12. Ue properly recommends fomentations of a hot and
dry nature, and friction with calefacient oils. When produced by a bilious
delluxion upon the stomach, he directs to give saltish water so as to operate
as an emetic. He makes mention of the bath, and in certain cases allows
wine. For Galenas sentiments, see de Di/f. Feh'. lib. ii., de Causis Sympt.
ii. 5, de Ineqitali Intemp., de Tremore^ Palp, et Rigor e. The last-mentioned
work, in particular, contains some ingenious speculations on the nature of
rigors. Our author has mentioned Galen's treatment.
Aetius states that tremors take place in Fevers for the most part owing to
errors in eating and drinking. Holding them to be connected with disorder
of the spinal marrow, he directs to apply to the back wool soaked in some
stimulant oil, or to put the patient into a bath of oil. He recommends
castor, both when taken by the mouth and applied externally with the em-
brocations. Lib. V. 130.
According to the explanation of Palladius, rigors and tremors are occa-
sioned by fumes or vapours arising in the internal parts, and being diffused
over the body. C. 24.
The treatment recommended by Haly Abbas is simple and judictous. He
directs to give draughts of hot water, to put the patient's feet into hot water,
and to rub the feet, and, if necessary, the other parts of the body, with cale-
facient oils and the like. Fract. iii. 20.
Avicenna gives a very accurate account of the different modes of treat-
ment, but they are much the same as our author's. He approves of ligatures
to the extremities, of rubbing them witli stimulant oils, or even with lini-
ments prepared with assafcetida and mustard. He says the bath of hot oil
is very beneficial. He also recommends draughts of hot water, and potions
containing opium, which, he remarks, will procure sleep and perspiration.
In certain cases, he allows hot wine, which had been recommended by Hip-
COMMJBNTART ON THB BBCONO BOOK. 217
pocrsites, (Apk. vii. 56.^ lie directs to open the bowels with the hiera, or
piils of assafcetida. Lib. iv fen. i. tr. 2. iihases particularly commends a
draught of hot water. Cont. lib. xxx.
XLVII. — ON 8WBAT8. «
Hippocrates has delivered many interesting remarks on Sweats which oc-
cur in Fevers. See Epidem, — Aphor, — Frognost, pauim.
Galen remarks that profuse Sweats are occasioned by rarity (i.e. relaxa-
tion) of the body, or redundance of the superfluity, or thinness thereof. The
perspiration is checked^ on the other hand, either because the superfluity is
small in quantity, thick, and viscid ; or because the pores of the skin are
constricted. £ither state, he adds, may arise from atony of the natural powers
of the flesh. De Causu Sympt. iii. 9. He says, in another place, that for
tlie removal of copious Sweats astringent and refrigerant remedies are indi*
cated, and that every thing of a relaxing nature ought to be avoided. He
recommends cold wine, and directs to avoid all hot things, also ligatures to
the extremities, emetics, and motion. He approves of cool air medicated by
sprinkling the apartment of the sick with austere things, such as myrtles,
vine shoots, and roses. Therap, ad Glauc. lib. ii.
Celsus directs, when the Febrile Sweats are slight, to rub the body with
oil, and, when more profuse, with roses, quince ointment, or myrtle oil, to
which austere wine is to be added. Lib. iii. 6.
Constantinus Africanus and his prototype Syuesius concur in directing
to check collequative Sweats, by rubbing the body with oil of myrtles, of
roses, &c. They commend an Fpiiheme made of a decoction of roses, the
flowers of the wild pomegranate, galls, and myrtle leaves, to which a proper
proportion of oil is to be added. They also direct to place beside the patient
Vessels filled with water, to sprinkle the apartment with myrtles, roses, &c.
to give him the syrup of roses in cold water, and to avoid exercise.
Serapion recommends styptic and desiccative applications, such as galls>
frankincense, alum, the flowers of vine, myrtles, and tlie like. De Antidotu,
vi. 20.
Haly Abbas briefly recommends friction with styptic oils, and to remove
the patient into a cool apailment. Pract. iii. 24.
Alsaharavius, in like manner, recommends friction with astringent oils,
ssuch as those prepared with roses, pomegranates, and the like. Tr. xxxi. § 2,
Avicenna and Rhases adopt the same plan of treatment as our author. The
tatter directs to rub the body with rose oil, or myrtle oil, to sprinkle the pa-
t.ient with rose water in the decoction of myrtles, to fan him, and to lay in
l^is chamber the tops of cooling herbs and trees. Continens, lib. xxxi.
Prosper Alpinus informs us, that the Methodists approved of cool air, of
Sprinkling the face with cold fluids, of rubbing the body with styptic oils,
^uid of giving astringent wines internally. He also mentions the application
^^f snow over the arteries of the extremities, and pouring cold water over
^hose of the wrist. It is to be regretted, however, that this author too fre-
^:^uently omits to quote his ancient authorities. See Medic. Method, vi. 18.
^nd vii. 3.
Van Swieten gives our author credit for his judicious directions respecting
^:;ool air, ventilation, and removing all superfluous coverings from the body,
^^e questions the propriety, however, of using oily and styptic applications
^o the skin, although be admits that, in certain cases, they might prove ad-
^^i^antageous. Comment. § 717. liogerius cautions not to stop Febrile
*^»weais inconsiderately ; but, when it is judged proper to interfere with
218 COMMBNTART ON THE SECOND BOOK.
them, he recommends to rub into the temples, and over the kidneys, sto-
mach, and spine, a mixture of albumen and rose water. When they occur
early, he directs to have recourse to venesection. The other earlier writers
on Medicine, likewise, treat this complication of Fever in the same manner.
XL VIII. ON COUGHS.
Galen gives some ingenious remarks on the causes of Coughing. He
states that, when any substance becomes fixed in the trachea, as it is a
cartilaginous and hard tube, and incapable of contraction, nature brings on
Coughing, by which a violent expiration of air is induced. A Cough, then,
is nothing but a violent expiration by which nature endeavours to expel any
body that obstructs the air passages ; and, when she cannot accomplish this
at the first effort, she repeats it once and again until she efiect her purpose.
He goes on to state, that such fluids as are very watery, instead of being
brought up, are merely divided or cut asunder by the current of air, while
such as are thick and viscid adhere so closely to the sides of the wind-pipe
that they cannot be removed, and hence violent efforts are necessary to ef"
feet the discharge of them. De Causis Sympt. ii. 4. He treats fully of
compositions for Coughs in his Work, de Comp. Med. sec, Loc. lib. vii. See
the 28th chapter of the Third Book.
Avicenna recommends Cough pills and lohocks made with poppies, the
cold medulla of fruits, starch, and the like. Lib. iv. fen. i. tr. 2.
The prescriptions of Serapion contain liquorice, sweet almonds, traga-
canth, and the like. De Antidotis, vii. 17. Those of Haly Abbas are very
similar. Tract, iii. 22.
A receipt is given by Rhases for Cough pills, the principal ingredients of
which are tra^acanth, sweet almonds, poppy seed. Gum Arabic, and Arme-
nian bole. Divis. i. 52. Many such receipts are given by Myrepsus.
According to Prosper Alpinus, the practice of the Methodists consisted
principally in the administration of demulcents, such as liquorice and al-
mond oil, with the internal application of various oily substances. De
Med, Meth, vi. 7.
XLIX« ON SNEEZING.
Galen explains that sneezing is a still more violent effort of natnre than
coughing, and that its intention is to remove irritating matters from the parts
about the nose, u, a.
Avicenna gives ample directions for the treatment of sneezing ; but they
are evidently copied from our author. Lib. 4. fen. 1. tr. 2. The same may
be said of Haly Abbas. Tract, iii. 22. Rhases recommends warm gruel
internally, to pour warm water on the head, and to apply oil of gouni, of
roses, and the like, to the nostrils. Cont. lib. xxxi.
Cassius Medicus discusses the question why rubbing the nose and eyes
stops sneezing. He supposes that it is by occasioning a discharge from these
parts, whereby the exciting cause is removed. ProbL 45.
L. — ON LOSS OF APPETITE.
Galen's explanation of the Philosophy of the sense of appetite is very in-
teresting. He remarks, that the appetite is a refined species of touch, the
seat of which is the mouth of the stomach, which, therefore, is supplied with
nerves direct from the brain. He goes on to remark, that the earth is to
COMMBNTART ON THB BBCOND BOOK* 219
plants what the stomach is to aDimals, supplying them with abundance of
food as long as it is moistened by seasonable rains ; but, when it becomes
parched by drought, the plants in like manner are dried up for want of du-
triment. (This comparison is borrowed without acknowledgment ffom
Aristotle.) To animals, then, as not being fixed to the earth (with a few ex-
ceptions), nature betowed a stomach which is to them a repository of food,
such as the earth is to plants, and she further gave them a sense of want by
which they have the desire of being filled with food and drink in due season.
This desire of being filled is called the appetite, which arises from a sense
of want, when the veins of the stomach absorb, and, as it were, suck from it»
whereby a painful feeling is excited, the proper cure of which is a supply
of food. The sensation then of sucking constitutes hunger. The loss of ap-
petite then may arise either from the sense of the sucking being lost, or from
the process of sucking (absorption ?) not taking place, or from the body not
being evacuated. De CausU Sympt, i. 7. He treats of stomach aifections
very fully in his work de Med. ttec. Locos, lib. viii.
Treatment similar to our author's is recommended by Alexander, lib. vii.
7, and by Oribasius, Si/nops, vi. 35.
Avicemia evidently takes his plan of treatment from our author, for he re-
commends emeticd, and afterwards fragrant things, with a plaster composed
of firuits laid over the stomach, and wormwood, aloes, &c. internally. Lib. iv.
kn. 1. tr. 2. c. 26. Among the causes of loss of appetite mentioned by him
in another place are, general disorder of the constitution in Fevers, severe
thirst, repletion with depraved humours, and insensibility of the mouth of
the stomach, so that it does not perceive the suction of the veins. Lib. iii.
fen. 1 3. tr. 2. c. 7.
Haly's treatment is nearly the same. He recommends fragrant food, and
fragrant wine after the acm^ of the fever, gentle laxatives, and such mode»
of exercise as he can bear. Fract. iii. 21.
LI. ON BULIMOS, OR INORDINATE APPBTITB.
AccoRoiKG to Galen, Bulimos is occasioned by a want connected with
^tony, and coldness of the stomach. De Camis Sympt, i. 7. Alexander on
^he other hand says, that it arises from inordinate heat and weakness of the
stomach. He informs us that the vulgar practice consisted in giving fra-
grant things, binding the extremities, rousing by pinching, giving bread
Soaked in wine, and, in short, administering every thing calculated to cool
«tiid strengthen the body. Others, he says, give opium with cold water, in
Order to extinguish the heat of the stomach. However, he disapproves oi
^11 these things, and directs to give food of difficult digestion. He relates
tHe case of a woman affected with Bulimia who was cured by having a pur-
gative powder given to her, which occasioned the discharge of a worm nK>re
t.ban twelve cubits long. Lib. vii. 6.
Aetius and Oribasius adopt the Theory of Galen, and recommend nearly
tlie same treatment as our author. Aetius also directs to apply over the.
stomach cooling cataplasms made of dates, quinces, or polenta, boiled in
<liluted wine.
Serapion remarks, that Bulimos is distinguished from the Canine Appe>>
t.ite, by the desire in the former complaint being for proper articles of food,
^vvhereas, in the latter, it is for depraved or improper food. His treatment
in most respects is like our author s. He also recommends a mixture of old
odoriferous wine, camphor, and lignum aloes. Tr. ii. c. 11.
Avicenna and Haly Abbas agree with Galen in stating that Bulimos is
<^«nnected with a cold interoperament of the stomach, whereby the sensibi-
220 GOMMBNTART ON THB SECOND BOOK.
lity and attractive power of the stomach are diminished. Their (reatroent in
principle is quite similar to our author's. In extreme cases they agree with
Galen in recommending the Theriac. One of Rhases' authorities recom-
mends cardamom, cubebs, and the like. Cont. lib. xi.
The Classical reader is referred to Callimachus for a grand poetical de-
scription of Bulimia. Hi/mnus in Cererem.
LIL— ON THB CANINB APPBTITB.
According to Galen, one of the causes of the Canine appetite is an acid
cacochymy, and another is an immoderate evacuation of the whole body, oc-
casioned either by strong heat or weakness of the retentive faculty, u. a.
Hippocrates recommends the liberal use of wine, in one of his Aphorisms,
lib. ii. 21 ; and Galen, in his Commentary on the same, states that the wine
should be tawny-coloured or red, and devoid of astringency. In another
place, he directs to purge away the offending humour witli the Hiera of
Aloes. De Med. sec. Locos, lib. viii.
Our author borrows part from Oribasius. S^nops. vi. 34.
Alsaharavius recommends the same plan of treatment as the Greeks, when'
the disease is connected with a cold intemperament ; but when with a hot,
he directs to have recourse to bleeding, cold fruits, and cooling applications
to the stomach. Pratt, xvi. c. 1 1.
Rhases and Avicenna approve in general of our author's plan of treat-
ment, to which, however, they suggest some improvements ; wnen the cause
of the complaint is an acid phlegm, they direct to give fatty things with mus-
tard, pepper, garlic, and the like. When connected with black bile, they
approve of bleeding. When it arises from worms, they, of course, approve
of Anthelminthics. Sarac, one of Rhases' authorities, recomm,ends emetics
and purgatives, with a cupping-instrument applied over the stomach. Ccm-
tinenSy lib. xi.
Serapion's treatment is entirely like our author's. Tr. ii. c. 10.
Prosper Alpinus, the modern advocate for the doctrines of the Methodists,
approves of our author's practice. Med, Meth, xi. 7.
LIII. ON THIRST.
The greater part of this chapter is taken from Galen (de Cans. Symp.
u. s,), who, as usual, handles the subject very philosophically. Oribasius
treats of it in nearly the same terms as our author. Spnops. vi.'37, 38, 39.
Aetius remarks that there are two causes of thirst, a want of humidity, or a
redundance of heat. In Fevers, then, both these causes co-operate to occa-
sion thirst ; for, there is excess of heat originally, and dryness comes on ow-
ing to the fluids of the body being consumed by the Febrile heat. Lib.
v. 119.
The question was keenly agitated in the ancient schools of medicine, whe-
ther cold drink might be safely given in Fevers. Hippocrates was a great
advocate for this practice, giving his patients barley-water and acidulated
draughts very freely at all periods. Asclepiades, on the other hand, as Cel-
sus and Alexander informs us, forbade even to wash the patient's mouth with
water during the first stage of a Fever. Celsus is disposed to hold a middle
course between these opposite methods of practice. He particularly ap-
proves of washing the mouth and fauces frequently with cold water, because,
as Erasistratus had properly remarked, these parts oflen require cold li-
quids, while the internal parts are not in want of them. Philumenus (ap.
OOMMBNTART ON THE SECOND BOOK. 321
Aetium) also strongly recommends gargles, but forbids to give cold drink
freely until after the acm^ of the Fever. Alexander informs us that the ce-
lebrated Archigenes allowed his patients the free use of cold water and aci-
dulated drinks. He himself does not speak very decidedly for or against
this practice. He approves, however, otcold applications externally; and>
accordingly, directs to apply to the region of tne stomach a bladder filled
with cold water, ice, or some cooling decoction.
Of the Arabians, Serapion expresses himself most decidedly in favour of
cold drink. Avicenna forbids to give much at a time. See also Haly Abbas,
Pract. iii. 22. Alsaharavius, Fract. xvi. 14. Averrhoes, CoUiget. vii. 24,
and Rhases, Contin. lib. xxx.
The pill mentioned in the end of the chapter is from Dioscorides.
It appears singular that all the ancient authorities should agree in stating
that liquorice quenches thirst, while the modems hold that it rather increases
it — (See Edinhurgh Dispensatori/.) And yet I can affirm that the common
people in Scotland are of the same opinion as the ancients. — De gustibtif
non est disputandum I
Prosper Alpinus seems to agree with the ancients as to this property ef
liquorice. He represents the Methodists as having disapproved of the free
use of cold water in Fever. Med. Meth. vi. 7.
Fabius Paulinus gives an admirable exposition of the philosophical doc-
trines of the ancients on this subject. He remarks that there are three dis-
tinct species of thirst. The 1st is occasioned by the fauces and sesophagas
being arier or hotter than natural. This state, if it supervene upon sleep,
is to be cured by watchfulness, or versa vice. In the 2d, the veins over the
whole body are filled with hot and acrid humours. In the 3d, the mouth
of the stomach, lungs, or heart, are pretematurally hot or dry. Marc, Pra»
kct. p. 315.
LIV. ON ROUGHNESS OP THE TONGUE.
This chapter is mostly taken from Oribasius. Synop. vi. 43.
Aetius recommends nearly the same treatment. He also states that, when
t'ie roughness of the tongue is difficult to remove, it may sometimes be ac-
^^mplished by rubbing it with the fat of fowls, or with fresh butter. Lib.
^- 118.
Ocelius Aurelianus directs to clean the tongue with a sponge squeezed out
^^ liot water. Avicenna recommends for this purpose an instrument called
^^<Mizarany and also directs to use sugar, or a sponge with a small quantity of
!^l( and rose oil. He likewise makes mention of the salt brought from
^^clia, possessing the colour of salt and the taste of honey. (Lib. iv. fen. 1.
?*"* 2. c. 22.) The Pseudo-Dioscorides recommends mint triturated with
^'^^Hey, red sumach, and rose oil with honey, or by itself. Eupornt. ii. 18.
X^rosper Alpinus was of opinion that the Indian salt mentioned by our
^^t.lior and Avicenna was the same as our sugar. Sprengel, however, main-
^ii:is, that the Greeks and Romans were utterly unacquainted with our
^^gar. Kei. Herh. Hist, and Notie in Dioscoridem. Lib. ii. 104. The
^'^el arundinum appears, in fact, to have been a natural concretion, and it
^^s most probably the same as the Indian salt. See Dr. Milword's Letter
^o Si|. Hans Shane. The Cane from which the ancient Sugar was procured,
^ now called by botanists the Bambusa Arundinaceoy or Bamboo Cane.
222 COMMBNTABT ON THB SECOND BOOK.
LV. — ON NAUBBA.
Obibasius recommends the same treatmeDt. S^nop, vi. 40. Our author
appears to have condensed the lengthy account given by Galen and Aetius.
Lib. ix. c. 5.
Alexandei: also treats of the subject at gpreat length, but I can only af-
ford room for a few extracts. When the nausea arises from plethora, he
directs to bleed ; and, when the plethora is connectei with vitiated humours,
he recommends both to bleed and purge. When Bilious* or Melancholic
humours occasion the nausea, he recommends dilution at first by giving te-
pid water or the like, and then directs to evacuate them by purging or
emetics. When the humour is an acrid or sweet phlegm, he recommends
oxymel, radishes, and the like. When a serous and thin humour is impact^
ed in the stomach, he directs to evacuate it by procuring vomiting witn te-
pid water or ptisan. Lib. vii. c. 13.
Serapion appeal's to have copied from our author. Lib. iii. c. 5. See Avi-
cenna, lib. iii. fen. xiii. tr. 5. c. 8. Rhases recommends to apply over the
stomach a cold plaster with snow. When the nausea is oppressive, he di-
rects to promote vomiting with tepid water. Cont, lib. xi.
Prosper Alpinus says that the Methodists approved of giving a weak aro-
matic wine in such cases, and that, when the stomach was very much loaded,
they administered emetics. Med. Meth, vi. 8. Sydenham was fond of giv-
ing emetics in cases of Fever attended with nausea. Van Swieten, however,
often found that, when administered early, they failed to afford relief: he,
therefore, preferred giving oxymel and the like, which, in the course of a
few days, usually had the effect of producing vomiting with great relief.
Upon the whole, the treatment recommended by Boerhaave and Van Swie-
ten is little different from our author's. They very properly forbid to use
emetics, when there is any reason to suspect inflammation of the Liver or
Stomach. See Comment, § 644. In the plague. Dr. Russel treated nausea
by giving draughts of tepid water, or small doses of Ipecacuanha.
LVI. — ON YOMITINO OF BILB.
This is taken from Oribasius, Si/nops. vi. 41.
Alexander states that the proper remedies for vomiting occasioned by a
redundance of bile, are diluents and refrigerants. He recommends internally
{>tisan, lettuces with a small quantity of vinegar, &c. For drink, he particu-
arly approves of cold water, but forbids to give much at a time. When the
strength fails, he permits to add a small proportion of hydromel, wine, or the
like, to the water. In certain cases, when the patient is troubled with in-
somnolency, he directs to add the heads of poppies to his drink. He also
recommends external applications possessed of tonic, cooling, and impellent
properties. Lib. vii. c. 17.
Serapion recommends not to interfere with a Critical vomiting. When it
is continued, he directs to give clysters and gentle purgatives at first, and
afterwards vegetable acids and astringents. When these remedies fail, he
directs, if the strength be good, to bleed from the arm. He also makes men-
tion of external applications, possessed of astringent and refrigerant proper-
ties. Tr. iii. 15. Haly Abbas, in like manner, cautions against stopping a
Critical vomiting. Pract, iii. 24. Alsaharavius directs to give draughts of
tepid water at first, and afterwards the infusion of wormwood or of aloes.
He also recommends external applications of a strengthening nature. Pract,
xvi. 20. Avicenna's plan of treatment appears to have been copied from our
V
COMMBNTART ON THB SECOND BOOK. 228
author's. Lib. iv. fen. i. tr. 2. Rhases recommends acid drinks, such as the
decoction of pomeg^ranates and the like. Coni, lib. xi.
According to Prosper Alpinus, the treatment of the Methodists consisted
in administering sub-acid fruits, the juice of wormwood or of mint in wine,
and in applying externally tonic Epithemes, containing sumach, galls, mas-
ticb, and the like. Med, Meth, xii. 1 1 .
Vomiting in Fevers b no doubt generally connected with a state of the
stomach and neighbouring parts approaching to inflammation. See an ex-
cellent account of the Vomitus Febrilis, by Van Swieten, Comment. § 652.
Vomiting is mentioned by all the writers on the Plague as a common and
un&vourable symptom of that disease. See Thucydides, and Russel on the
Plague, p. 92.
LVIL— ON HICCOUGH.
This chapter is copied from Oribasius, Si/nops, vi. 42.
According to Galen's explanation, Hiccough is occasioned by any exciting
cause which rouses the stomach to violent motions. He states that sneezing
proves a cure to it. De Cans. Sym, iii. 6. Celsus says, in like manner, << Sin-
gultus stemutamento finitur.'' He states that frequent and unusual bickuping
is symptomatic of an inflamed liver. Lib. ii. 7. Aetius, in like manner says,
that singultus in Fevers often arises from inflammation of the stomach and
neighbouring parts. He treats of the complaint at great length. When it
arises from pungent humours, he directs to give first emetics, and afterwards
narcotics, such as opium, &c. He also recommends to apply a cupping-
instrument with great heat to the breast, stomach, and back, in certain cases.
Lib. ix. 5.
Alexander gives an interesting account of this affection, for which he re-
commends various remedies. When connected with inflammation of the
stomach or liver, he directs to begin with bleeding. When it is occasioned
by thick and viscid humours, he recommends an oxymel of squills, the com-
position of which he minutely describes. Lib. vii. 15.
When singultus is connected with a,cold cause, the author of the Euporis-
ton ascribed to Dioscorides, recommends to put the feet into hot water, to
take tepid draughts, and apply hot fomentations to the stomach. Lib. ii 4.
Though there is perhaps nothing original in the views of the Arabians,
they treat of hiccough very fully and accurately. Among the causes of it
mentioned by Aisaharavius is inflammation of the stomach and liver, in
which case he recommends venesection. When connected with excessive
heat of these parts, he approves of cold air, cold drink, and refrigerant
draughts, containing prunes, tamarinds, camphor, Src. Tr. xvi. 18. The
causes of hiccough, according to Sempion, are, evacuation, repletion, pun-
gent and cold humours. His remedies are emetics, calefacients, and attenu-
^ts, which are to be directed according to the nature of the exciting cause.
Tr. iii. 17. See also Avicenna, lib. iii. fen. 13. tr. v. c. 25., Rhases,
Bwis. 62., ad Mansor. ix. 65., ContinenSf lib. xi. Rhases recommends ca-
le&cients, such as cumin, pepper, rue, and the like, in vinegar. He also
approves of emetics and laxatives.
Prosper Alpinus says that the ancient Methodists approved of Oily Eme-
tics. Meth. Med. vi. 8. It will be remarked, that our author states that
^ny persons are seized with hiccough if they take peppers with wiue.
^sper Alpinus mentions that they had this effect on him (de Pras. v. et
n. M^r. iii. 9.); and 1 have further to state the same of myself.
Hogerius, probably copying from Rhases (for the practice of the earlier
DQodem physicians is mostly borro\<red from the Arabians), recommends prin-
224 COMMBNTART ON THX SECOND BOOK.
ci pally cale^Eicient, attenuant, and carminative medicines, mixed witli gentle
laxatives, such as prunes. Tr. iii. c. 21. For Hiccough in Intermittents,
Cleghom recommends to apply a cuppins-instrument to the pit of the sto-
mach, and give laudanum with tincture of castor internally.
LVIII. ON CONSTIPATION AND DIARRHOSA.
Galek forbids venesection when the Fever is complicated with Diarrhoea.
Therap, ud Glauc, lib. i.
When the belly is constipated, Celsus recommends laxatives, diuretics,
and sudorifics. lie adds, it may also be proper to let blood, practise gestation,
enjoin abstinence from food and drink, and keep the patient from sleeping.
He likewise recommends the bath, both of tepid water and of oil. When the
bowels are loose, he enjoins rest and sleep, directs to restrain sweating, and
forbids all exercise except gentle gestation. He also directs to excite vomit-
ing by copious draughts of tepid water, unless the complaint be of long
standing, or there be pain of the throat, prscordia, or side. Lib. iii. 6.
Alexander forbids to use Narcotics, unless in cases of extreme urgency.
Avicenna joins him in laying down this injunction, and otherwise directs to
treat the Diarrhoea Febrilis upon general principles. Lib. iii. fen. 16. tr. 1.
c. 4. Haly Abbas directs to treat Fever, when complicated with constipa-
tioD, by giving gentle laxatives, such as prunes aud tamarinds, or, if these
prove injurious to the stomach, by administering clysters. When the Diar-
rhoea is complicated with a discharge of blood, he recommends to add to the
other medicines Armenian earth, purslain, sumach, or such like astringents.
Pract. iii. 24. See Serapion, tr. iii. 17., Hhases, Divis, 67.
According to Prosper Alpinus, the ancient Methodists approved of astrin-
gent applications and astringent clysters for Febrile Diarrhoea. Med, Meth.
▼i. 10. Sydenham and Van Swieten agree with Alexander and Avicenna in
forbidding to stop Diarrhoea in Fevers by means of opiates, unless in ex-
treme cases.
liogerius discusses fully the question of the propriety or impropriety of
bleeding in cases of Fever complicated with Diarrhoea. Upon the whole, he
rather disapproves of it, unless the system be strong and the symptoms vio-
lent. He approves of assisting nature in the way she points at.
LIX. — ON TRICKLING OF BLOOD AND HBMORRHAGB FROM TBB
NOSE.
Hippocrates declares that profuse bleeding at the nose indicates a dis-
position to convulsions which venesection is calculated to remove. Pradict,
i. 21. Galen, in his Commentary, remarks that the convulsions are broi^t
on by the unseasonable use of cold applications to stop the hemorrhage. He
strongly recommends to bleed from the arm of the side from which the blood
flows. In another place, he states that Epistaxis in Acute Fevers is an un-
favourable symptom. In. iii. Epidem. Comment.
Aetius mentions that Hippocrates had declared a bleeding from the nose
on the fourth day of a fever to be a very bad symptom. He recommends to
encourage the bleeding by irritating the nostrils with a stalk of grass. Oar
author, it will be observed, directs to perform this operation with the T^m,
a species of grain several times mentioned by Theophrastus, in his History
of Plants, by Galen (Je Aliment, i. 13.), and by Alexander Trallian (lib.
vii. 5.) Sprengel makes it to be a species of Secale or Rye ; but Stack-
COMMBMTABT ON THB 8B0ONO BOOK. 225
house, the English editor of Theopfarastus, is of opinion that it was the
TVt^tctMi SpeltOy or Spelt. *
When it is judged proper to restrain the hemorrhage, Avicenna recom-
mends ligatures to the extremities, and cold and styptic applications to the
nose and adjoining purts. Lib. iv. fen. i. tr. 2. c. 14. and lib. iii. fen. v. tr. 1.
Serapion agrees witn most of the ancient authorities in commending a mix-
ture of frankincense and aloes, when applied on the down of a hare. He
also directs to apply a sponge soaked in cold water to the temples and fore-
head. Tr. ii. 13. When bleeding at the nose occurs in a fever, Rhases for-
bids to stop ity unless it prove excessive; in which case, he directs to apply
a cupping-instrument, without scarification, to the hypochondrium ; to tie
ligatures about the testicles; to pour cold water on the head ; and to driidL
cold water. Divis. 40.
Boccacio mentions Epistaxis as a fatal symptom of the Plague of 1 348. —
Decameronf IrUrod, Dr. Russel found it an un&vourable symptom of the
plague of Aleppo.
According to Prosper Alpinus, the ancient Methodists forbade to stop a
Critical Epistaxis, unless it proved excessive, when they approved of cooling
tieatment, as recommended oy our author. Med, Meth. vi. 10.
Rbgerios remarks that it is an important point to determine whether the
Epistaxis be a Critical evacuation or otherwise, as, in the former case, it
ought not to be meddled with. When it appears not to be Critical, be di-
rects to produce revulsion, by bleeding at the arm, and to apply astringents
to the forehead and sides. Tr. iii. c. 19. The other earlier writers adopt
the ancient views in like manner.
LX« ON DBLIQUIUM ANIMI.
l^EABLT the same account of Deliquium Animi in Fevers is given by
AetiuSy^Lib. v. 101, et teg.) and by Oribasius, {<ie Morb, Curat, iii. 7.) But
-^11 these authors are, in fact, indebted to Galen. Therap, ad Glanc, lib. i.
Aetius thus states the distinction between Syncope and Deliquium : — << De-
liquium makes its attack suddenly, depriving the person of sense and mo-
"tion, but is not necessarily accompanied with sweats ; but Syncope seizes
"^pon persons, both when asleep and when awake, and is necessarily attended
"With sweats, called Syncoptic.''
Alexander delivers a ftiU account of the subject; but his principles of
"^eatment scarcely differ in any respect from those of Galen. Lib. xii. 13.
Haly Abbas directs, when the Deliquium proceeds from a defluxion of
^Himours upon the stomach, to apply ligatures to the extremities, to dash water
^^>n the face, to fan it, and to give vinegar and pepper. He recommends to pre-
sent sleep, which has a tendency to extinguish the powers of the primary
'^cera, by occasioning a determination inwardly. When it proceeds from
'dryness, he directs to give wine, the decoction of quinces, of apples, and the
^ike. If it happen at Uie commencement, he recommends to give a piece of
^>read soaked m wine. Tract, iii. 25.
The Arabians in general do not acknowledge the distinction between Syn-
<5ope and Deliquium.— See Averhoes, Colliget. vii. 16., Serapion, vi. 19.,
Phases, od JUofisor. X. 13.
Avicenna seems to point at the distinction, but it is not perceived by his
^nnslator."'' Rhases recommends the same treatment as Haly Abbas. He
i^ommends hot wine, food of easy digestion, sprinkling of the face with cold
^ater, and the application of ligatures to the extremities. Continens, lib.
nxi.
226 OOMMBNTABT ON THB SBCOND BOOK.
Fainting and Syncope are most commonly met with in Pestilential Yeren.
See Russel on the Plague, p. 89.
LXI. ON ULCBBATION OVBR THE 08 SACRUM.
This chapter is taken from Oribasius, Synops, vi. 44.
Aetius remarks that, in prolonged Fevers, the fleshy parts of the body be-
ing wasted, ulceration takes place in those parts upon which the patient lies.
These sores, he adds, spread deep, and have hard thick edges. When the
back becomes red and painful, he directs to surround the adjoining parts
with a circle of wool, so as to relieve the affected part from the effects of
pressure ; and then a cerate of rose or myrtle oil, containing litharge, ceruse,
and burnt barley, is to be applied. He particularly commends a composi-
tion consisting of litharge, oil, wax, and honey, mixed with rose-oil. He also '
makes mention of the applications recommended by our author. He con-
cludes with directing to use milder applications when the ulceration has
stopt spreading. Lib. v. 127.
Alsaharavius directs to treat the redness of the back occasioned by lying
long in bed, with the flower of millet, barley, or lentils. When pustules
form and break, he recommends to apply an ointment containing ceruse.
Pract. xxix. §. 1. c. 26.
APPENDIX
TO THK
COMMENTARY ON BOOK SECOND.
ON 8MAHiL-P0X AND MEASLES.
The reader, I am sure, would be disappointed, if I were to quit the subject
of Fever, without making any allusion to the history of Small-Pox and
Jdeasles. I will, therefore, conformably with my general plan, give a brief
:aK>tice of the descriptions of these diseases which we meet with in the works
<^>f the ancient physicians. In the first place, then, I may mention that, after
Kaving read every word of eveiy ancient writer on medicine that has come
"^own to us, I can confidently a&rm that the Greeks and Romans are alto-
^gether silent on the subject, and that we are indebted to the Arabians for the
^^arliest accounts which we have of these diseases*. Rhases, indeed, pretends
^^provided the Introduction to his Treatise on Small-Pox be not spurious) that
^Cklen had delivered some imperfect descriptions of Small-Pox ; but he
ould appear to have been led into this mistake, by following some iuac-
urate translation of the Works of Galen into the Syriac language ; for no
which would justify the interpretation which Rhases puts upon
em are now to be found in the origmal. lately, Dr. Bateman attempted
< show, that allusions to Measles and Small-Pox are to be met with in the
orks of several of the Greek authors; but I entirely agree with Drs. Mead
d Freind, who maintain the contrary. In an Arabian MS. preserved in
e University of Leyden, it is stated that the Small Pox and Measles first
ppeared in Arabia, about the year 572, p. c. — See Reiske, Opuscula Medicuj
.10.
Although Rhases be the most ancient writer whose account of Small-Pox
^-Dd Measles has come down to us, he does not pretend to have been the first
^^f his countrymen who had noticed them, but gives extracts from the Works
^^f the Elder Mesne, the Elder Serapion and Aaron, wherein mention is made
^^ithem. According to Rhases, the common cause of Small- Pox is a fer-
^^entation in the blood ; and hence the disease is most apt to seize children,
^^^hose blood is hotter than that of other persons. He was well aware, how-
^'^^r, that the disease is capable of being propagated by contagion, for he
^^nks the Pestilential Fever or Small-Pox among the diseases '* qui transeunt
^^uno ad alios.*' The symptoms, as described by him, are, continued fever,
V^in in the back, itching at the nose, disturbed sleep, and afterwards redness
q2
228 AFPBNDIX TO THE COMMENTARY ON BOOK SECOND.
and fulness of the face, pain of the throat, difficulty of breathing, diyness of
the mouth, thick spittle, hoarseness, headach, inquietude ; and these symp-
toms are followed by the characteristic eruption of the Small-Pox or
Measles ; but in the case of the latter there is more anxiety of mind, sick
qualms, and heaviness of heart ; and in that of the former there is more pain
in the back, heat, and inflammation of the whole body, especially in the
throat, with a shining redness. He then lays down the rules of treatment.
He directs to bleed from the arm at the commencement, provided the patient
be more than fourteen years old, but by a cupping-instrument if he be younger.
He forbids, however, to abstract blood after the eruption is come out. He
allows to take light kinds of animal food, with acids ; and for drink he re-
commends water cooled with snow, or cold spring water, or some diluent
and acid draught, such as' barley-water acidulated with pomegranate juice.
Aaron, one of his authorities, forbids, however, to give cold water when the
eruption is coming out. He directs to sprinkle the chamber with cold water,
and even at a certain stage permits the patient to go into the cold bath. He
recommends abstinence from new milk, wine, dates, honey, mutton, beef,
shell-Bsh, and all high-seasoned and heating things. The rest of his general
treatment 1 need not give in detail. Suffice it to say, that the medicines re-
commended by him are, for the most part, vegetable acids and astringents.
Upon the whole, the earlier part of his treatment consists of bleeding, cold
drinks, and acid draughts. For hastening the eruption, he directs to wrap
up the patient closely in clothes ; to rub his body all over; to keep him in a
room not very cold; to give him some cold water to drink; to put on a
double shirt ; and to place near him two small basins of very hot water, one
Defore, and the other behind him, so that the vapour may be diffused all
over his body, except the face ; but he prudently directs not to allow the
moisture to cool upon the body, but to get it carefully wiped off. All fujp-
naces and hot baths he condemns, as overheating and weakening. He very
much commends figs for promoting the eruption. He afterwards gives very
minute directions about the treatment of particular parts, such as the eyes,'
the throat, and the nose. For the eyes, ne recommends various astringent
lotions or colly ria, such as galls and rose-water, sumach, pomegranate rind,
&c. The care of the throat he justly holds to be a very important considerar
tion, and recommends to bleed when there is acute , pain, and to gargle
with cold water, or with astringent decoctions, such as those of acid pome-
granates, sumach, and the juice of mulberries. When the pustules on the
limbs are large, he directs to open them ; and, when there is great pain in the
soles, he recommends to rub them with warm oil, or to put the feet into hot
water. When the pustules seem to stand in need of ripening, he directs
foment the body with the steam arising from a hot decoction of camomile^
violets, and the lik&; and, when too humid, the patient is to be laid
pounded roses, rice meal, or millet seed. For removing the scabs
eschars, he recommends to rub them with the warm oil of sesame, or oil
pistaches; but the larger are to be cut off carefully without any application:^
of oil. For removing the specks on the eye, he recommends many stimulac^c
collyria, containing antimony, verdigris, sal ammoniac, tutty, camphor.
For removing cicatrices or marks on oUier parts of the body, be mentioi
various applications, containing litharge, bastard spurge, &c.* When
belly is loose, either in Small-Pox or Measles, which, as he remarks,
commonly the case on the decline of the Fever, he recommends to abst
from all laxative things, and to give barley gruel, to which the meal of
megranate seeds may be added ; or, if the looseness increase, gum aral
&c. may be added to the drink. He adds, that it sometimes happens
the bowels require to be opened, and he directs to effect this by mean;
niyrobalans, prunes, and the like. When in Measles there is much appear-
AFPBNDIX TO THE COMMENTARY ON BOOK tXCOND. 229
ance of vitiated bile, he directs to procure the discharge of it He points
out the difference between Distinct and Confluent Small-Pox ; and remarks,
that the latter isiar more dangerous than the other. He also correctly states,
that when, in Measles or Small-Pox, the eruption is suddenly determined in-
wardly, it is a fatal symptom. He all along inculcates, that Measles and
Small-Pox are nearly allied to each other; and I may mention, by the way,
that the learned Dr. Mead is of the same way of thinking. He !»ays, " The
Measles have a great affinity with the Small-Pox, being originally bred in
the same country, and propagated in the same manner by infection into
distant parts of the world, and never seizing any person but once." The
simultaneous occurrence of Small-Pox and Measles in certain cases, will be
admitted as a presumptive proof of a certain alliance between the two
diseases. — (See Mr. Delagarde*s Paper in the Medico-Chirnrgical Transact
t'umsy vol. xiii. p. 1.) I may mention further, that Sidobre, Sennertus, and
most of the authorities of that period, maintained this opinion. Even Syden-
ham holds them to be of the same nature.
Georgius, one of the authorities quoted in his Continent^ says that Measles
arise from blood mixed with much bile, and Small-Pox from gross blood
mixed with much humidity. He states that the danger is proportionate to
the pain in the throat and difficulty of brefathing. The Elder Serapion, as
quoted by him in the same work, directs, if it is the winter season, to bum
the wood of Tamarisk, &c. beside the patient.
In his work Ad Mansorem, he recommends nearly the same treatment as
that which we have been detailing from his Tractatus on Small-Pox ; but
does not speak so decidedly in favour of cold drink.
Avicenna's description of Small-Pox and Measles is very similar to that
of Rhases. He conhdently pronounces them to be contagious diseases; He
states correctly, tliat, when Small-Pox proves fatal, it is usually from the af*
^^tion of the throat, or from the bowels becoming ulcerated. Sometimes, he
^dds, the disease superinduces bloody urine. He agrees with Rhases that
Measles is a bilious affection, and that it differs from Small-Pox only in this,
Uiat in the former the morbific matter is in smaller quantity, and does not
pass the cuticle. His treatment also is little different. At any period dur-
ing the first four days he approves of venesection, but forbids it afterwards.
^e recommends cooling and diluent draughts prepared from tamarinds, and
the like. He directs to give figs to facilitate the eruption of the pustules, and
^rbids to give cold drink after they begin to come out. When the pustules
^*e large and fully formed, he approves of letting out their contents with a
Sold needle. His treatment of the throat, eyes, belly, and hands, is nearly
the same as that recommended by Rhases. When ulcers are formed after
t^e falling off of the eschars, he directs to dress them with the White Oint-
Hcieuty composed of Ceruse and Litharge. — See Lib. iii. fen. 1. tr. 4.
Serapion*s account of Small-Pox and Measles, as is remarked by Haly
A.bbas, is very defective. He treats of them along with apostemes, and his
description of the symptoms is far from being accurate.
Avenzoar, in his Treatise on Epidemical diseases, treats incidentally of
l^easles and Small-Pox, for the cure of which he recommends principally
gentle purgatives, such as tamarinds, with cooling and acid drinks. Lib. iii,
Ir. 3. c. 4.
Alsaharavius also mentions them briefly among the Pestilential diseases;
"but his deserrption of them is not to be compared with that of lihases.
According to Haly Abbas, Variola is produced either by external causes,
such as a Pestilential state of the atmosphere, or from respiring the air of a
place which has been tainted with the effluvia from the pustules of persons
uffected with the disease; or it may arise from an ebullition of the blood
vrhenitis loaded with gross humours which nature endeavours to cast out-
230 AFPXNDIX TO THB COMMBNTART ON BOOK BBCOMD.
wards. He then briefly describes several f arieties of the disease, differing
from one another in degrees of malignity; and among them he ranks
Rubeola, which is occasioned, he says, by a hot thin blood, and is not of a
bad nature. In it, he says, the eruption, when at its height, resembles mil-
let seeds, or is somewhat larger, the colour is red, and the pustules discharge
nothing. The precursory symptoms of Small-Pox are, Fever, swelling of the
face, itching ot the nose, inflammation and redness in the face and other
members, heaviness of the head, and roughness of the throat. TAeor. viii.
14. With regard to the treatment of Variola and Rubeola, he recommends
venesection during any of the first three days; or, if the patient be a child,
he directs to apply a cupping-in.strument to the back. The patient is then
to be made to drink barley-water, in which jujubes and sebesten plums have
been boiled ; syrup of poppies is to be added, if the cough be troublesome, or
the pain of the throat severe; and spoon-meats prepared with spinage, orach,
and the like, are to be given. When the eruption does not come properly out,
he recommends a decoction of fennel, lentils, figs, &c. to be taken cold. (By
the way, this practice is favourably mentioned by Fracostorius, a writer of
the t6th century, de Marb, Cont,) When there is asperity in the chest, he
directs to give the mucilage of fleawort, linseed, and the like, and forbids
all heating things. The patient is to be kept npon a low diet,** as in other
Fevers; and his apartment is to be fumigatea with aromatics, such as sandal-
wood, myrtles, and roses. When tlie belly is constipated, he directs to give
barley-water with manna, prunes, and the like; or, if loose, barley-water
with myrtle seeds, gum Arabic, Armenian, or Ci*etan earth (chalk ?). He
forbids to give purgatives after the 7th day, especially in Rubeola, as there is
danger of diarrhcea or dysentery being superinduced ; and, if tliese affections
should come on, he directs to stop them with astringents. He recommends
to pay particular attention to the eyes at the commencement, and with this
intention directs to bathe them with an astringent decoction. No animal
food is to be allowed, until the eruption and heat are gone.
HEADS OF THE THIRD BOOK.
This Book, which is the Third of the whole Work, treats of Topical
complaints, beginning with the Head and ending with the Toes.
1. On Alopecia, Ophiasis, and Baldness.
2. Compositions for Dyeing and Curling the Hair.
3. On the Affections of the Skin of the Head.
4. On Headach.
5. On Cephelsea and Hemicrania.
6. On Phrensy.
7. On Phlegmon of the Brain.
8' On Erysipelas of the Brain.
9. On Leftliargy.
10. On Catochus, or Coma Vigil.
11 • On Loss of Memory and of Reason^ Carus, and Fatuity.
12. Oq Vertigo.
13. On Epilepsy.
1^' On Melancholy, Mania, and Dssmoniacs.
15. On Incubijs, or Night-mare.
^^' On Lycaon, or Lycanthropia.
^^* On Lovers.
^^' On Apoplexy, Hemiplegia, or Paralysis.
^^' Oq Spasm.
^^. On Tetanus, and its different yaneties.
2^- OuTiemblkigs.
22. On Complaints of the Eye.
^^' Matters relating to the Ear.
^^- On Affections of the Nose, and of the Sense of Smell.
^^' On Affections of the Face.
^^" On Affections of the Mouth.
*^' On Quinsy, and Affections of the neighbouring parts, also on those who
are Strangled or otherwise Suffocated.
*^' On Coryza, Catarrh, Affections of the Trachea, and Cough.
^- On Orthopnoea, Asthma, and Dyspncea.
232
30. Od PiieumoDJa.
31 . On Spitting of Blood.
33. On Empyema and Phthisis.
33. On Fleurisjt.
34. On the Affections of the Heait.
35. On AffeclloDs of (he Mamnw.
36. On Offensive Smells and Exudations of Ihe Ann-pits.
3T. On Affections of the Stomach, Urpochondria, and Belly.
38. On Ineation of the Stomacli.
39. On Cholera and Diarrhcpa'.
40. On Lienteria and Caliac ASections.
41 . On Tenesmas.
43. On Dysenter)'.
43. On Colic.
44. On Ileua.
45. On AfTectiona of the Kidneys and Bladder.
46. On Affections of the Lirer.
47. On Cachexia.
48. On Dropsies.
49. Od the Spleen.
50. On Jaundice.
51. On Prolapsus of the Navel.
52. HowtoinaketbeHairof theChinandPobeslateofGrowth; alsoon
the Preserration of the Privy Parts and Testicles; and likewise of
Depilatories.
53. On Bnboitocele, Gnlerocele, and Hydrocele.
54. On InSammatioQ of the Testicles and Scrotum, and other Complaints
of those parts.
55. On Gonorrhcea, and Polluted Dreanu.
56. On Satyriasis.
57. On Priapism.
58. On Impotence.
59. On Affections of the Pudenda and Anus.
60. On Affections of the Uterus,— and, firet, of Uie Menstrual Discharge.
61. On lUtention of the Menses.
62. On Immoderate Menatruitiou, and Hemorrhage of the Uterus.
63. On the Female Discharge.
64. On Inflammation of the Uterus, and Displacement of the same.
65. On Abscess of the Uterus,
66. On Ulceration of the Uterus.
67. On Cancer.
68. On Scirrhus, and the Hard Tumour called Scleroma.
69. On Hole.
TO. On Inflation.
71. On Uterine Suffocation, or Ihe Hysterical ConTuIsion.
288
72. Od Prolapsus of the Uterus.
73. On Phimus of the Uterus.
74. Cure of Barreuness.
75. On Fissures, Condylomata, and Hemorrhoids.
76. On Difficult Parturition.
77. On Ischiatic Disease.
78. On Gout and Arthritis.
79. On Chilblains, and Complaints of the Sole and Heel.
80. For Corns and Callus.
81. On Complaints about the Nails, — and, first, of Paronychia.
PAULUS iEGINETA.
BOOK THIRD.
I. — On Affections of the Haitf Alopecia, Ophiasis, and
Baldness*
As some plants die from dryness for want of sap^ and some frdm
the sap being onsoitable to them, so is it in like manner with te
hairs ; for baldness is occasioned by want of the natural juices* aad
alopecia and ophiasis by the badness of them. These complidttts
di£^ only in figure ; for, in the latter, the affected part has tiie mp^
pearance cf a serpent; and alopecia deriTCS its appellation fnmt
the circumstance of foxes being frequently subject to the afieetiiNi.
Judging of the prevailing humour, then, from the colour of tite
skin, we are first to evacuate it by purging, and then to have re-
course to local appliditions. If, therefore, the colour incline to
black or white, we purge with the medicine called hiera, which
evacuates both phlegm and the melancholic humour ; but, if it is
palish, we give pills of aloes. An account of these medicines will
be found in that part of our work which treats of compound medi-
cines. After general depletion, we are to use masticatories oom'-
posed of vin^ar, mustard, and honey, and not once only, but fre-^
quently. It will be better, too, if marjoram, penny-royal, th3n]ie» or
hyssop, had been infused in the vinegar. In all the other compleliits
of the head, the same method is to be observed, first evacuating tiie
prevailing humour, either by purging, or by phlebotomy if there be
a fulness of blood, and then proceeding to the topical treatmmit.
On Alopbci a. -—Having first cleansed the part with nitre, and
scrubbed it with a rough cloth, more particularly a woollen-cloth«
and continued the friction until it become red, anoint it with yer-
vain pounded with vinegar in the sun. Or, rub in the roughest
alcyonium burnt and pounded with lamp-oil. Or, bum the root of
the club-rush, or the rind of the bitter almond, and rub theia in
with oil, or wolves* tallow. These are moderate remedies. But
236 PAULUS iEGINETA.
stronger applications may be prepared from euphorbium, thapsia,
and adarce, pounded with oil of bays, or liquid pitch. Another : —
Having burnt the shells of sea-urchins, mix them with wolves' tal-
low, and rub with them, having first cleansed the part with nitre.
Another : — Of pepper, of dried sheep's dung, of hedge- mustard, of
rocket-seeds, of each, dr. iv. ; of white hellebore, dr. iii. ; of mouses'
dung, dr. i : add to the gall of a bull, of a goat, or of a hog.
Another tried remedy for alopecia : — Of the root of mandragora, of
birthwort, of the root of wake-robin, of wax, of liquid pitch, oz.
viii. ; of swines'-seam not salted, of the heart or inner part of the
herb nerium a little : boil the seam and the nerium until the herb
be softened ; strain and throw away the herb, and add to the axunge
the other ingredients, and boil. Add the wax and the liquid pitch,
and use boldly in the sun. When the ulcers are cicatrised, burn
the head of a fox, take alcyonium, the leaves of the black alkanet,
and, having pounded all together, sprinkle upon the ointment, in or-
der to promote the growth of the hair. Another : — Of a mouse's
head burnt, one part ; of the shells of the sea-urchin, one part ; boil
in a pot with swine's-seam, and use. They may also be sprinkled
in powder.
A Medicament from Thapbia for all Chronic Affections. —
Of euphorbium, of thapsia, of bay -berries, of each, oz. i. ; of native
sulphur, oz. ss. ; of hellebore, oz. ss. ; of wax, oz. viij. ; of oil of
bays, or old castor oil, q. s. When stronger applications are re-
quired, add of cardamom, oz. i. ; of burnt alcyonium, oz. i. ; and it
will be applicable not only for alopecia, but for all cases of chronic
coldness. But in every case of tdopecia, have recourse in the first
jdace to the process of cleansing with nitre, then friction, and fre-
quent shaving. I have seen many have their hair reproduced by
friction alone, and frequent shaving.
For Baldness, and in order to Increase the Growth of
Hair, from Crito. — ^Take the dried stomachs of five hares, roast
carefully in an earthen vessel, add to them the third part of myrtle
tops, of the fruit of acacia, of the juice of acacia, of sweet-briir, an
equal part, of maiden-hair, oz. iii. ; pound all these things together,
and sift through a small sieve. Then, adding of wolves' tallow lb.
iv., of that of a seal the same quantity, pound, and preserve in a
leaden vessel. At the time of using, add to any fragrant ointment.
Preservatives of the Hair. — Of maiden-hair, one part; of
ladanum, two parts ; add to wine and myrtle-oil, and use. An-
other : — Pound the flower of anemone, and rub it in with oil. The
same will blacken the hair. Another : — Pound the straight vervain
dried with its roots, sift through a narrow sieve, and, having mixed
with oil so as to have the thickness of the bath-sordes, lay it up in
a copper vessel, and, when softened, use instead of oil in like
manner.
A Watery Infusion for Increasing the Growth of the
Hairs, and for Blackening them. — Of rain water, six sextarii ;
of Alexandrian sumach, three sextarii ; of maiden-hair, oz. iv. ; of
savin, oz. iv. ; of ladanum, oz. i. ; of m3Ttle, oz. i. ; of dried gourd,
BOOK THIRD. 287
OE. i. ; allow to macerate in a glass vessel for twenty days, stirring
it t^ice a-day with a pine spat^a. On the following day, plunge the
comb into the infusion, and use once a-day. And the seed of marsh-
mallows, when rubbed in while in a bath, preserves the hair, and
promotes its growth. And, in like manner, oil may be rubbed in
that has had marshmallows boiled in it, or added to it.
For Thinning thb Hair. — Of the leaves of the iig-tree, of liie
rind of the white wild vine, of pumice stone, of the shells of hoc*
cinse, of Cimolian earth, of each, one mina. Put them into a new
crude pot, and, having covered it with clay, bum in a furnace, and
pound, adding of aphronitrnm half a mina, of the galls called om-
phacitm thirty in number, pulverise and use. Another : — Of aphro-
nitrnm, half a mina ; of roasted pumice stone, four minse ; of fissile
alum (alumen scissilej, of dried iris, of the black wild myrtle, of
gum, of the root of bryony, of each, dr. iv. ; of unripe lupines
pounded, the fourth part of a gallon ; use without tallow.
For Falling out of thb Hair. — Rub in aloes with black aus-
tere wine ; or, the cover of the purpura boiled with oil ; or, m3nrh
and ladanum, with wine and myrtle oil ; or, pound burnt sheeps-
dung on a shell, and rub it in with oil, having first shaved the head.
II.— For making the Hair Curled, and for Dyeing them*
From Cleopatra,
Having first scrubbed the head, anoint the hair with the root of
cow-parsnip in undiluted wine. Another : — Having shaved the
head, and scrubbed it, take a young pine-kernel, and burn it until it
be reduced to ashes, put it into a mortar and pulverise it, adding
myrtle ointment, until it be of the thickness of honey, and thus anoint
the head with it. Another : — Rub in equal parts of myrtles and
beet, with oil. Another : — ^Twenty galls ; of maiden-hair, oz. ii. ;
pound with sea-water until they attain the thickness of honey.
Having rubbed the hair with urine or lixivial ashes, and cleaned
it with warm water, anoint it with this medicine for two days,
then stopping, on the third day clean it, and, having shaved, anoint
with myrtle oil. This will render the hair smooth, curled, and black ;
but it will be more curled if you will shave before using it.
Prbservativbs of Hoary Hairs, and other Compositions
FOR Dyking them Black. — Of the oil of unripe olives, three sex-
tarii ; of spikenard, dr. i. ; of unguis aromaticus (sweet-hoof f),
dr. iv. ; of schsenanth, dr. iv. Boil with oil, and separately pound
aud dissolve carefully one ounce of the juice of acacia in wine.
When only a third part of the oil remains, strain it, and, mixing
with the acacia, lay it up in a vessel, and anoint with it every day.
Another : — Of the bark of green walnuts, oz. iii. ; of the root of
the ilex, oz. iii. ; of dark-coloured wine, three sextarii ; boil to a
thirdrpart, and, having strained, pound the remainder with one
sextarius of myrtle oil. To be used every day.
An Infusion for Dyking the Hair Black. — Of galls, one
238 PAULUS iEGlNETA.
•extarius ; of elm-leaved Bumach (rhus coriaria), two sextarii ; of
the leaves of privet, an equal quantity ; of black myrtle leaves, the
same ; of cennaris, a handful ; of poppy-heads, the same ; of lake-
water, twelve sextarii. Macerate for many days, boil to a third,
then rub and anoint the head. When the hairs are dry, anoint
with an acetabulum of Cimolian earth, and an equal quantity of
quick-lime. Dissolving these things in the juice of boiled beet,
anoint with it, and then, for the sake of protection, put over it the
leaves of beet, and, when they adhere properly, wash in the bath
with it.
For Dyeing Tawnt Hair, and Making thbm of a Bright
YxLLOw Colour. — ^Take of m3m'h, one part ; of the flower of salt,
one part ; pulverise carefully, and, having made it of the thickness
of the sordes of a bath, scrub the head, anoint it with the ointment,
and allow it to remain a night and a day, and then order it to be
wiped off. Another : — Rub in unripe lupines with water. Another :
— Of litharge, dr. i. ; of Cretan earth, dr. iv. ; of quick-Ume., dr.
i. ; with water make to the thickness of bath sordes, and anoint.
Apply the leaves of beet for two or three days, and then dean.
For Making Black Hairs Yellow. — Add the lees of wine to the
sordes of a bath, and, having made it to the consistence of cerate,
use it when you are going to sleep, and in the morning the hairs
will be yellow. Another : — Macerate the leaves of privet in the
juice of Fuller's herb (struthiumj, and use the infusion.
A Gold- coloured Dye. — Of alum, dr. vi. ; of red arsenic, dr.
vi. ; of saffron, dr. ii. ; of the thapsus used by dyers, called rubia
by the Komans, dr. viij. ; of the lixivial ashes used by the bonnet-
makers, four sextarii ; boil the ashes and the thapsus pounded to-
gether, and, when but one-half remains, squeeze out the juice, and
dissolve in it the alum, red arsenic, and saffron ; put it into a glass
vessel, and, at the time of using, first scrub the head, and then
anoint with it. When it is all drunk up, clean with the decoction
pf fenugreek, barley, and cumin, having previously washed them
with a sufficiency of tepid water, and add as much as is required.
Another : — Mixing together the burnt lees of wine and the oU used
in the baths, anoint the hairs. Another : — Scrub with Gallic soap
and water at each bath. Another very fine : — Of red sumach, a
sextarius ; of galls, lb. i. ss. ; of sheeps' dung, oz. ii. ; of the
golden-coloured herb, called rubia by the Romans, oz. ii.; of
maiden-hair, two fasciculi ; of wormwood, one fasciculus ; of lu-
pines stripped of their outer coat, two cyathi ; of water, six sex-
tarii ; put all into a glass vessel, and allow to macerate for nine
days, stirring it twice a day. At the time of using, strain out
what is required, and, soaking a sponge in it, rub the hairs, and
when they are moistened allow them to drink it up. When dried,
wash with a solution of soap in warm water.
For Making the Hair White. — Bum the flowers of the white
petty-muUein, moisten with vinegar, and mix for a detergent
ointment. Another : — Of the fruit of petty-mullein, dr. i. ; of
BOOK THIRD. 299
alum, dr. i. ; of the rind of radbbes^ dr. i. ; pound, and mix of
bulla' gluten, dr. iy.
Ilh-^On Pityriani.
PiTTBiABis is an eruption of small furfuraceoua aubstancea on the
skin of the bead, or the rest of the body, without ulceration. It ia
occasioned, either by depraved humours which have been determined
to the bead, or by a saltish phlegm, or by bilious or melancholic
blood. After the general system has been evacuated, as formerly
described, we must use some of the under-mentioned remedies.
Macerate Cimolian earth in water, mix with the juice of beet, and
anoint with it, allowing it to remain until dry, then wash it away,
and, having pounded frankincense with wine and oil, anoint with
them. Next day, rub in stavesacre with oil. Another : — Of nitre,
of the burnt lees of wine, of ben nut, of each, lb. i. ; of stavesacre,
lb. i. ss. Dissolve in wine, and rub the head ; or, if the rest of
the body be affected with tingling, it may be used dry. When the
Pityriasis is more humid, wash with brine or the decoction of
lupines. Of this remedy I have had ample experience.
On Pstpracia ANn Exanthemata of thb Hbad. — ^The psydra^
cia are small protuberances, like blisters, elevated above the skin.
The exanthemata are superficial ulcerations, somewhat red and
rongh. Both are to be cured by the under-mentioned remedies :—
Of Utbarge, dr. iv. ; of ceruse, dr. iv. ; of alum, dr. ii. ; of the green
leaves of rue, dr. ii. ; pound with vinegar and myrtle oil, and anoint.
Another :— -Pounding rue and alum with honey, anoint with this
the bead, after having first shaven it. If the head is excoriated,
^ply olive leaves boiled with honey. Another : — Of litharge and
cemse, <^ each, dr. xii. ; of native sulphur, dr. viij.; mix witi^
myrtle cerate.
For thb Thick ANn Rsn Ulcbrs of thb Hbad rb8bmbi»im«
Papuiijb, or small Nipplbs, from which Ichor is discharobp.— p-
Having first shaved the head and scrubbed it with water and
nitre, use native sulphur livigated with human urine ; or anoint
with melantena and vinegar.
For Achorbs and Favi. — The complaint called achor is one
of those which affect the skin of the head, corroding the skin by
very small perforations, from which a discharge of viscid humour
takes ]^Ace. The complaint called favus is nearly allied to it in
appearance, since it consists of larger perforations resembling the
combs of bees, containing a honey*like fluid. They are occasicmod
by a nitrous and saltish phlegm. In such cases, the diet should
consist of wholesome food ; and every thing that is acrid and saltish
should be avoided, more particularly if the attack be inflammatory.
After the proper evacuation of the prevailing humour, having
shaven the hairs, foment twice, thrice, or oftener, with warm water,
in which has been boiled myrtle, or bramble, or lentil, or bitter
lupines, ot the root of asparagus. When the ichorous discharge is
240 ^AULUB JSOINSTA.
greater, 9l^\j a cataplasm of the leaves of willow, with water, or
of lentil. The ointments used should consist of Cimolian, Cretan,
or Samian earth, or pomphol3rx, or spodium, or litharge, or cad-
mia, or humt paper, or the powder from pepper. All these are
to be applied with vinegar. We may use the following smegma : —
Of snlphur, of the herb perdicias, and soap, of each, equal parts.
Tke following are compound applications :— Of litharge, dr. xvi. ;
of the leaves of me, dr. viii. ; of the stavesacre, dr. iv. ; of copperas,
dr. ii. ; with vinegar and myrtle oil ; make to the consistence of bath
sordes, and anoint with it. Another : — Of sand3rx (calcined ceruse?) ,
dr. iv. ; of myrrh, dr. iv. ; of native sulphur, dr. ii. ; of manna, dr.
iv. ; rub into the part with old oil.
For Achorbs. — ^When they discharge ichor, triturate the dross
of silver, or yellow ore of lead (molyhdoBna) , and sprinkle upon them.
Another, for achores and humid psora :---Of the roses of the rho-
dodaphne, oz. iv. ; of native sulphur, oz. iv. ; of liquid pitch, oz.
iii. ; of dry pitch, oz. iii. ; of wax, oe. vi. ; of myrtle oil, q. s,
FcH* children, dissolve in milk, and anoint.
For Fici. — We give the name of fici to ulcerous excrescences
which are round, somewhat hard, red, and accompanied with pain.
They arise for the most part on the head, but iJso sometimes on
the other parts of the body. The best application for this com-
pbunt, consists of fissile alum ; of the calcined flowers of copper ;
of taurocolla, of each equal parts, with double the quantity of the
flakes of copper ; triturate with vinegar, and anoint. A proper
application is also prepared from the burnt heads of the cackrel fish,
the bulbi boiled, and their ashes mixed with vinegar.
A DRT APPLICATION FOR FlCOSB ERUPTIONS OF THB HbAD AMD
Chin. — Of misy, dr. i. ss. ; of chalcitis, dr. ii. ss. ; of squama
seris, dr. i. ; of fissile alum, dr. i. Having washed, apply this in
a dry state unsparingly, and allow it to remain. Next day, having
again washed, wipe the part with a sponge, and apply it again. A
thick scab will then fall from the ulcer. Repeat the same applica-
tion the following days. The cure will be efiected in a few days
without leaving a cicatrix ; but this medicine operates strongly.
For Licb in thb Hbad. — Direct to scrub the head with the decoc-
tion of lupines ; or pound together stavesacre and sandarach, and
rub them in, along with oil or vinegar ; or a small quantity of
pepper may be added to old oil, so as not to occasion ulceration ; or
the juice of ivy with honey may be used ; or mustard and vinegar;
or the gum vernix, or liquid pitch with alum ; or the expressed juice
of the bay berries ; or oil of radishes. I have always succeeded by
pounding stavesacre with vinegar and oil, and anointing with
this.
l\.—On Headach.
Hbadach, which is one of the most serious complaints, is some-
times occasioned by an intemperament solely ; sometimes by a re '
BOOK THIRD. 241
dandance of humours, and sometimes by both ; and sometimes it is
occasioned by a procatarctic cause, such as external heat, or cold,
or drunkenness, or a blow. The most vehement pains of the head
are excited by the active qualities, particularly heat. Those occa-
sioned by dryness are not equally vehement ; but a humid quality
excites no pain of itself, unless it happen to be joined to heat,
cold, or a fulness of humours. Headachs occurring in a fever
having been treated of in the Book on Fevers, we will now treat
of the others. *
On Hbadach from Heat. — When headach proceeds from ex-
posure to heat, the skin feels hotter and drier than natural at the
first application of the hand, and the eyes of such persons are red.
They delight in cold afflusions and ointments, and are benefited by
them. The method of cure will correspond with that described as
applicable for cases of headach in fevers. When the pain becomes
chronic, we must have recourse to some of the under-mentioned ap-
plications. The following applications to the forehead and temples
vrill also be proper, namely, bread soaked in oxycrate and rose-oil,
to which may sometimes be joined almonds ; or roses either dried or
fresh, or mixed with mint and penny-royal ; or bread with the leaves
of the peach tree. Benefit may also be derived from basil, pounded
^th vinegar and rose-oil ; or from ivy berries boiled in vinegar,
and pounded with rose-oil ; or from wheaten flour mixed with the
yffKtiry decoction of wild thyme ; or from cardamom toasted and
triturated in vinegar and rose-oil ; or from yeast with rose-oil ; or
from dried iris with vinegar. These applications must be changed
frequently ; for, if allowed to remain long, they have no effect.
TitOCHISKS FOR HbADACH OCCASIONED BT A WaRM InTEMPBRA-
^SNT. — Of safiron, dr. v. ; of copperas, dr. x. ; of alum, dr. xvi. ;
of myrrh, dr. vii. ; of the oil of unripe olives, dr. iii; of chalcitis,
dr. iii. ; of gum, dr. iii. ; of austere wine, q, s. Use with oxy-
crate, and, if watchfulness accompany it, add some soporific.
On Hbadachs from a cold Intbmpbrament. — In cases of head-
achs from coldness, the symptoms are just the reverse of those pro-
ceeding from heat ; for the face is pale and not contracted, and the
patients do not delight in cold things, nor arc benefited by them.
The diagnosis will also be confirmed, by adverting to their di^
and the like. The ointments applied should contain rue, or the
oil of bay, or of iris, or of nard, or the juice of balsam, more par*
ticularly if the excrementitious humours be thick and viscid. This
must be rubbed into the forehead, and likewise preparations con-
teioing pepper and euphorbium. We must also give attenuant
%vines, and recommend exercise, hot baths, and occasionally an
emetic from radishes. When the exciting cause is a chronic
quality without plethora, we may use the following application :—
Of white pepper, dr. ii. ; of croco-magma, dr. ii. ; of fresh euphor-
l)ium, dr. viii. Ss. ; of pigeon's dung, dr. i. Ss. ; of the strongest
vinegar, q, 9, Having first rubbed the affected part, anoint with
this.
On Hbadachs from a Bilious Humour. — ^The symptoms re-
r
242 PAULUS iEGINETA.
semble those occasioned by heat, only there are more gnawing pains
at the stomach, paleness of the countenance, and sometimes a bitter
taste in the mouth. This affection occurs most frequently in adults
who are of a hot temperament, lead an anxious life, and are subject to
collections of yellow bile. They must use tepid baths, and mild
ointments, with a watery drink ; and their whole diet should be
humid, and consist of good juices. The bilious humours must be
evacuated with the decoction of worm-wood, or with aloes, or the
antidote called hiera picra, either alone, or in combination with a
little scammony, or the aloetic pills. The forehead is to be rubbed
with the saffron trochisk, that called Trigonos, or the like.
On Hbadach from Sympathy. — If the head be affected sympa-
thetically with the general system, this must be our first care, by
attending to the intemperament and the prevailing humour. If it
proceed from plethora, more especially a venous one, we will bleed ;
but, if it be only an offending quality, we must use a purgative
medicine. If the head sympathise with some particular part, such
as the liver, belly, or stomach, we must apply remedies to these
organs. If a hot intemperament accompany, we give bread which
has been steeped in a watery wine, or spoon-meats from chondrus.
Moderately cooling and tonic applications are likewise to be used ex-
ternally, as formerly described. But, if the headach be occasioned
by viscid and thick humours contained in the stomach, these must
be dislodged by drinking oxymel, either alone, or that preparation
called the Julian. We must also use decoctions of hyssop and mar-
joram, and other things still hotter and more incisive, and likewise
the emetic from radishes, hot embrocations, and cataplasms.
On Hbadach from Wink. — If the wine remain undigested, we
must procure vomiting, by drinking tepid water ; but, if the head-
ach remain after digestion, we must use cooling and repellent ap-
plications, such as rose-oil alone and with vinegar, or the juice of
ivy, or of cabbage. And the leaves of cabbage infused in warm
water, and applied to and bound to the head, naturaUy coimteract
intoxication. They must also eat boiled cabbage. Dried len^l is
also beneficial, particularly to those who have a loose belly. They
ought likewise to eat alica, pomegranates, apples, and pears, and
drink water.
On Hbadach from a Blow. — ^We must immediately bleed those
who have headach from a blow (unless the injury be superficial),
and use suitable embrocations to the head ; bathe it with sweet oil ;
cover it with wool ; and make the patients abstain from wine and
a rich diet, more especially if they have fever ; and, upon the whole,
we are to accommodate our treatment as for the infiammation of
nervous parts, and especially of the membranes of the brain. If
there be a wound it must be treated accordingly.
An Emollibnt Application for Hbadach. — Of wax, dr. vii. j
of almond oil, oz. iii. ; of turpentine, dr. viii. ; of scraped verdigris,
of Cimolian earth, and of chalcitis, of each, dr. iv. ; of
stone, dr. iii. ; of burnt copper and scales of steel (squanue siemo-
BOOK THIRD. 248
math), of each, dr. ii. ; and, if it appear to be too hard, soften it
with almond oil.
V. — On CephaUea and Hemicrania,
Each of these affections is a permanent pain of the head, liable
to be increased by noises, cries, a brilliant light, drinking of wine,
and strong-smelling things which fill the head. Some feel as if
the whole head were struck, and some as if one-half, in which case
the complaint is called hemicrania. When the affection is seated
within the skull, the pain extends to the roots of the eyes, and
when externally it spreads around the skull. Pain, then, accompanied
with heaviness, indicates plethora ; if with pungency, acrimony of the
humours or spirits ; if with throbbing, inflammatioti ; if with tightness
and without heaviness and throbbing, a fulness of a thin and fla-
tulent spirit (gas?) ; but, if it be attended with throbbing, it is in-
dicative of inflammation of a membrane ; if with heaviness, of a ful-
ness contained within the membrane. If the putrid humour acquire
heat, the headach will be attended with fever. And, ii) general,
those in whom headach proceeds from inflammation have fever.
When, therefore, the whole body is in a plethoric state, we must
bleed (attention being paid to the strength), and use the more acrid
clysters. Should there still appear to be a fulness of blood, we
must open the veins of the nose, and endeavour to evacuate there-
by to a sufficient amount. We must then give hiera sharpened
with vinegar, and use masticatories, or medicines for evacuating
the phlegm by the mouth ; also procure evacuations from the nose
by means of errhines, such as the juice of elaterium, which may be
poured in with milk ; or the elaterium may be snuffed up dry, or
else the juice of sow-bread or of leeks. The following are com-
pound medicines : —
An Errhinb for Chronic Headachs, Ophthalmt, and Epi-
X.EPST. — Of gith (mgeUa sativa), dr. viij. ; of sal ammoniac, dr. iv. ;
of elaterium, dr. iv« ; pound and mix with Sicyonian oil, or that of
iris, or of privet, so as to have the thickness of cerate, and apply to
the nostrils.
An Errhine to be Snuffed up. — Of dried sow-bread, dr. viij. ;
of red nitre, dr. iv. ; or, if instead of the nitre, you will use ela-
terium, it wiU be still better. Snuff it up through a reed. In more
chronic cases, use epithemes to the head and unguents, as the fol-
lowing : —
An Epithemb for Cbphaljea. — Of the ointment of iris, of hogs-
femael and castor, of each, dr. i. ; of bay-berries, dr. ii. ; of the tops
of rue, dr. iv. ; mix with rose-cerate, and, having shaven the head,
apply to the whole of it. A certain woman, by using the following
application in cases of hemicrania, acquired wonderful celebrity : —
Having cut down the green root of the wild cucumber into small
pieces, she boiled it and worm- wood in oil and water until they
were softened ; and, with the warm oil and water she fomented
r2
244 PAULUS ^GINETA.
moderately the affected part ; and, pounding the root and the worm-
wood, she made a cataplasm of them. And with this application
she cured cases of hemicrania, both with fever and without. When
a strong paroxysm takes place, so that the pain is insupportable,
use paregoric and alterativie applications like the following : —
An Unguent for Cephaljba. — Of the juice of hog*s-fennel, dr.
xvi. ; of the juice of poppy, of anise, of henbane, of sa^on, of
myrrh, of scammony, of each, dr. ii. Add to vinegar and make
trochisks. When using it, anoint those who have pain of the head
from thick humours or a flatulent spirit with it, along with vinegar
or oxycrate. We must, likewise, use a dropax and sinapism, and
the trochisk from thapsia. That, too, from writing ink is much ap-
proved of for the same cause, and is to be used, as will be described
in the Book on Compound Medicines.
The following one is possessed of wonderful efficacy for hemi-
crania proceeding from a thick and viscid humour : — Of euphor*
bium, one part ; of castor, an equal quantity ; and, mixing with
water, insert into the ear of the affected side, and order the patient
to go into a bath, and, when he has remained a short time, take it
out, and bathe as usual. Thus it is of tried efficacy. It will not be
improper also to add them to oil, and inject into the ear. The ap-
plication described for ischiatics is likewise a successful remedy for
chronic headach and hemicrania.
For Chronic Hemicrania. — Of garlic, dr. iv. ; of wax, dr. ii. ;
of old axunge, dr. ii. ; of cantharides, dr. ii. Apply this in the
evening, and, having allowed it to remain all night, break the blis-
ter in the morning, and cure with the plaster called Panygms.
Another : — Of bay-berries stripped of their skins, dr. ii. ; of the
leaves of rue, dr. ii. ; of mustard, dr. i. ; moisten with water, and
apply. It is most beneficial to those whose complaints arise from
cold causes, so that frequently, when applied before going into the
bath, it immediately cures the affection, and after the bath they
become perfectly well. Another: — Of Sabine oil, lb. i. ; of wax,
oz. iii. ; of euphorbium, oz. i. ; with this anoint the half of the
forehead, namely along the temporal muscle. If the cold is not
great, pound galls and crocomagma in equal quantity with wine,
and anoint. In cases from hot fumes or humours, do not use the
applications with euphorbium.
An Apophlegmetism, or Masticatory, for Cbphaljba and
Hemicrania. — Of mustard pulverised and dissolved in vinegar and
honey, oz. xiv. ; of stavesacre, dr. iv. ; of pellitory, dr. iv. ; having
pounded, strained, and mixed in the sun, gargle with it. When
the cephalsea becomes permanent, owing to a bilious humour or
some intemperament, use the remedies formerly described for head-
ach. If after all this the pain continue, even after cupping and
leeching, and there is reason to suspect that the distribution by the
arteries is affected, it will not be improper to open the arteries be-
hind the ears. In those of a humid intemperament, the natural
baths may be tried with good effect. Another for hemicrania : —
BOOK THIRD. 245
Mix euphorbium and earth-worms with vinegai^ and anoint the af*
fected part, or the whole forehead.
« VI. — On Phrenitis,
Phrbnitis is an inflammation of the membranes, the brain also
being sometimes inflamed along with them, and sometimes a preter-
natural heat fixes originally in the brain itself. The cause of this
disorder is either a fulness of blood, or of a yellow bilious humour ;
and sometimes the yellow bile, being excessively heated and con-
verted into the black, becomes the cause of the worst species of
phrenitis. And sometimes the affection arises from the brain sym-
pathizing with the diaphragm by means of the nerves distributed
upon it. But the aberration of intellect which occurs at the acm^
of very hot fevers, and that which is occasioned by sympathy with
the stomach, is not called phrensy but delirium. Cases of true
phrenitis are, for the most part, attended with watchfulness, bat
sometimes with disturbed sleep, so that the patients start, leap up,
and cry out furiously ; when the complaint is occasiomed by a san-
guineous humour, with laughter ; but when by yellow bile, with
ferocity ; and when by a black, with unrestrainable madness.
They forget what is said and done by them, their eyes are blood-
shot, and they rub them ; they are sometimes squalid, sometimes
filled with tears, or loaded with rheums. The tongue is rough,
there is a trickling of blood from the nose, they pick at flocks of
Wool and gather chafl^, and have acute fever during the whole con-
tinuance of the disorder. When a fever of a bad character is seated
deeply, they have the pulse small and indistinct, with a certain de-
^ee of hardness. The respiration is large and rare when the brain
is primarily aflfected. And, if the phrenitis be occasioned by sym-
pathy with the diaphragm, the respiration is irregular, the hypo-
chondria are retracted and hot ; but, when it arises from sympathy
with the brain itself, the parts about the face are hot and suffused
"^vith blqod, and the veins are full. When a pituitous humour is
rnixed with the bilious, as the cause of the disease is compound, so
a.l80 is its appellation ; for it is called Coma vigil. When a bilious
Ixnmour prevails, persons so affected are troubled with watchfulness;
^nd, when a pituitous is the cause, they lie in a state of Coma. Be-
fore Galen, this disease was called catochus, but since then it has
en called catoche and catalepsy.
Thb Curb of Phrenitis. — If the strength admit of blood-let*
ng, we are to abstract blood from the arm immediately and
^ireely ; but, if the patient be delirious and will not present his arm,
^^x if there be apprehension of hemorrhage after the bleeding from
'tlie patient tearing his arm during the agitation of his delirium, we
^^nust open the straight vein in the forehead, and take away at once
^ sufficient quantity of blood. We are to use clysters and injec-
tions of oil, or rose-oil with the juice of ptisan. When watchful-
ness prevails, we anoint the head with rose-oil, or with vinegar and
246 PAULUS yEGlNETA.
rose-oil ; iii some cases fomenting it with hot water ; and we must
give the medicine from the heads of poppy, unless prevented by the
weakness of the patient's powers ; and must have recourse to the
other remedies for insomnolency formerly mentioned. Let the pa-
tient be laid in a place which is in a moderate state as to light and
temperature, and let there be no paintings in it, for these are apt
to excite emotions in such casres. J^et some of his most beloved
friends come in and converse with him in a suitable manner, some-
times gently soothing him, and at other times chiding him more
harshly. His food at first should consist of honied water, and ^ter-
wards of the juice of ptisan, or spoon-meats formed from chondras,
with some sweet potion, such as apomel, or hydroroeatum, or rho-
domel, or the sweet hydromel. But the vinous hydromel which is
brought from Cebyra in small vessels must be rejected, as it pro-
duces more mischief than wine itself, especially in afiections of the
head and before concoction. We are also to administer bread that
has been soaked in water, and succory, and boiled lettuces. Or, if
there be much effervescence, they may be given raw, and also the
medullary part of the cucumber, of the pompion, of apricots, and
the like. They must abstain from cold water, more especially if
the afiection be found to proceed from sympathy with the dia-
phragm. If their urine (as is likely) be retained, owing to their
delirium, we must foment the lower part of the belly and bladder
with warm oil and water, and then, by applying the fingers of the
hand to the part, we must try to incite him to make water. We
must also anoint the rest of the body with warm oil ; and the pa-
tients are to be kept in a recumbent postm'e, for a state of quie-
tude is to be maintained as much as possible ; and, if they be rich,
they are to be restrained by their servants ; but, if not, they are to
be bound with ligatures. For irregular motion is apt to produce
prostration of the strength. And for another reason, too, the feel
ought to be bound with ligatures after having been bathed, and
friction applied to them, namely, for the sake of revulsion. But. if
the attack be more protracted and difficult to remove, we must ab-
stain from all narcotics ; and to the fomentations of the head are to
be added things of a discutient nature, such as the juice of mint, or
of wild thyme, or of calamint, or of rue ; and then we must use :
errhines. After the seventh day, if the viscera be inflamed, we
to soothe them by cataplasms of linseed and raw barley-flour ii
oil and water. We are then to apply dry cupping or cupping witfac^
scarifications to the parts, and to the back-part of the head and th^^
spine. But, if the body be observed to be very squalid and hot cJ
even if the fever remain, we must use baths of fresh water, ai
plentiful anointing, and give some thin and weak wine, in order
rouse the strength ; for we need not apprehend any mental alieni
tion that will thereby be produced. For, either it will not
place at all, as the disease is on the decline, or, if it do, it may
easily removed. When the disease further abates, we must bai
recourse to gestation and suitable restoratives. Recovery may
BOOK THIRD. 24/
promoted by avoiding intoxication, anger, indigestion of the food,
and more especially exposm'e to the heat of the sun.
VIL — On Phlegmon of the Brain.
Whbn the brain is inflamed, it is often so swelled that the su*
tares of the skull are separated. The pain is very strong and per-
manent ; there is much anxiety, and much redness of the counte-
nance, with swelling ; the eyes protrude, and the head swells. We
must let blood from the arm, and also detract by the nose, and from
the vessels below the tongue. We are also to use the fomentations
suitable for inflammations of the head, and cataplasms of a moist-
ening and concocting nature.
VIII. — On Erysipelas of the Brain,
Ebtbipblas occurs also in the brain, and the patient suffers in
the following manner: — He has pain of the whole head, and feels
as if there were fire in it ; his face is cold and pale, and his mouth
dry. Wherefore, bleed such a patient, and more particularly ab-
stract blood from the veins under the tongue, and apply cooling
things, such as we use in other kinds of erysipelas.
IX. — On Lethargy.
Lbthargt, which is a lesion of the rational part, has the same
^eat as phrensy, I mean the brain, but the matter which causes it is
of an opposite nature ; for it is occasioned by a humid and cold phlegm
irrigating the brain. It is attended with an obscure fever, which
is not very pungent, and with somnolency. The pulse is large,
rare, and imdulatory ; the respiration is very rare and weak. Le-
thargies are altogether disposed to sleep ; are roused with difficulty ;
can scarcely be made to answer questions ; are forgetful and deli-
rious ; they yawn frequently, and remain sometimes with their jaws
distended, as forgetting to shut their mouths ; their evacuations by
the belly are generally watery, but sometimes on the contrary the
^Uy is dry ; their urine is like that of cattle. Some have trem •
Idlings and sweatings. Garus being occasioned by the same matter
«us lethargy differs &om it in this, that fever precedes cams, and is
more violent, whereas it is subsequent in lethargy; and in this
respect also, that cams often supervenes upon other complaints, for
it often follows paroxysms of fevers, epilepsy, and compression
of the brain, as from the bone in fractures, or from the meningo-
phylaX pressing upon the anterior ventricle of the brain ; whereas
lethargy has a certain peculiar formation.
Thb Curb of Lbtharoy. — When the strength permits, we must
open a vein ; but, when it does not, we must use acrid clysters. We
248 PAUl^US ilCGlNETA.
must also lay the patient in an apartment of large »ize, and having
a moderate degree of light, and apply to the head an embrocation
of oil to which castor has been added. Some instead of the oil
use vinegar and rose- oil with the castor, by which they strengthen
and warm the head at the same time. And, having anointed the
rest of the body, particularly the extremities, with old oil, they sti-
mulate them with calcined nitre, pellitory, pepper, or the granum
cnidium. It is also possible, by making them into a cerate with
castor, to use them in this way. We must likewise apply strong-
scented things, triturating thyme, maijoram, and penny-royal, with
vinegar. We may smear the mouth and palate with mustard
I>ooHded in a small quantity of honey, and we may even remove
with the lingers the phlegm which adheres to it. And, rf they will
admit it, it is proper to use a masticatory consisting of oxymel with
hyssop, penny-royal, maijoram, or mustard itself. We may give
also in their drink things of a diffusible nature, more particularly
the Diospolites, to the amount of a spoonful, with oxycrate. When
there is chronic trembling, we must give two or three scruples of
castor ; or, if there be a redundance of humours, and there be no-
thing to contra-indicate the use of it, we may add a scruple of
scammony to the castor. When the disease is protracted, the head
must be shaven and fomented with salt, millet, and the like, in
small bags ; and sinapisms are to be applied to the whole head, and
medicines used to excite sneezing. Afterwards we may apply dry
cupping, with much heat, or cupping with scarifications, to the back
part of the head. It will be necessary to attend to the natural eva-
cuations by means of clysters and diuretics. Apply to the lower
part of the belly an embrocation with oil of rue, or Sicyonian oil
with some castor. We must also attend particularly to the deglu-
tition, injecting, by means of a vessel with a narrow mouth, warm
water, to which has been added some sweet potion, more especially
apomel. And, if there be inflammation in the intermediate parts,
we must cure it with embrocations and cataplasms. To the nose is
to be applied mustard triturated with vinegar, or burnt castor.
Their food should consist of ptisan, or the decoction of uats, or that
of alica, with oxymel, salt, or penny-royal, sometimes giving of it
every day, and sometimes only every alternate day. After food,
ligatures are to be applied to the extremities, which may also be
bent back ; and the limbs are to be pinched, and sometimes we may
even tear the hair violently in order to rouse them. Rubefacients
to the thighs and legs are also proper. When the affection is in
the decline, we may enjoin proper gestation, direct the bath to be
taken, and a restorative diet to be used.
X. — On CatochuSy or Coma Vigil.
Wk have already in treating of phrenitis mentioned the forma-
tion of this disease, the symptoms whereof in general are the sams
as those of phrenitis and lethargy, being modified according to th-
BOOK THIRD. 249
prevailing matter. The peculiar symptoms are these : — Tlie patieutt
remain fixedly stretched in a sapinc posture, having sometimes
their countenance somewhat swelled and livid like those in lethargy,
and sometimes with a florid redness in it; the upper eyelid seems
drawn upwards and projecting so that they cannot wink. They
seem also not to hreathe, but to be as dead. The pulse is small,
indistinct, and very dense. The discharges from the bowels and
bladder are suppressed, or in small quantities. When the attack ia
moderate, they drink whatever fluid is poured into the mouth ; bat
those who are overpowered by it reject the same by the nose.
Those, therefore, in whom the phlegm prevails over the bile, we
distinguish from those affected with lethargy by this, that there is
no swelling present, nor is the colour livid like lethargies, except
to a very small degree ; and that they perspire moderately. The
cases are difficult in which there is much watchfulness, the urine is
suppressed, the difficulty of breathing is intense, when they have
sweats, and the drink regurgitates by the nose. If it be a woman
that is affected, the complaint may be distinguished from uterine
suffocation, by the circumstance that she lies in a natural state, is
sensible when spoken to, can be roused, but sinks again into a state
of sopor. Some say that catochus is a different complaint from
the Coma vigil, for that it has not a compound, but a simple cause ;
namely, a cold and dry matter which obstructs the posterior ventri-
cles of the brain, and occasions the disease ; in which case, the
patient being suddenly seized with it, remains in the same posture
as when taken with it, that is to say, standing or lying, with his
eyes open or shut. The ancients, therefore, called such patients
catochi, which signifies detained, but the moderns call the complaint
catoche and catalepsy. The cure resembles that which is described,
but is to be varied according to the difference of the symptoms.
The Curb of Catochus. — Wherefore we must have recourse to
venesection, more especially when the face is ruddy, and the
strength does not prohibit ; and use clysters sometimes stimulant,
when phlegm prevails ; and sometimes emollient, when bile pre*
vails. In like manner we are to apply other remedies, and give
food sometimes every day, and sometimes only every alternate one.
The affection is very dangerous when produced by an error of the
food or ^drink, in which case the patient is to be made to vomit
immediately, and kept upon a restricted diet ; and the bowels are
to be stimulated, and an embrocation with cumin or rue applied to
the belly. They who have been seized with the complaint from in-
toxication, after their surfeit has passed off, must be cured by using
a more liquid diet, such as the juice of ptisan. And the head is to
be smeared with suitable ointments, which, if in summer, may be
cold, but tepid, if in winter. If the surfeit do not pass off, nor the
patient recover his senses, it will be time to give up the case as
helpless, and decamp to a distance.
250 l'AUL,US ^OINETA.
XL — On the Loss of Memory and of Reason; on Cams and
Fatuity.
The loss of memory sometimes occurs alone, and sometimes along
with impairment of the reason, as an impairment of the reason
sometimes happens first by itself, and is followed by that of the
memory. When both suffer, the affection called fatuity is formed.
These complaints have for a cause the exciting intemperament ; but,
if it is humid only, it will occasion impairment of the memory and
reason, torpidity, drowsiness, long and deep sleep ; but, if compli-
cated with coldness, it will produce cams and lethargy. In like
manner, dryness alone brings on watchfulness, but when joined
.with heat, delirium and phrensy. These intemperaments may be
seated in the fluids, in the cavities of the brain, or in its vessels ; in
the chyle diffused over the system, or in the substance of the brain ;
or else the temporal muscles may be affected. If the humours are
mixed together, they will produce this affection. Whether the
exciting intemperament be simple or compound^ may be learned
frofn the appearance of the excretions. That the loss of memory
and of reason springs from cold we readily ascertain ; but whether
it be accompanied with humidity or dryness, we judge of from the
discharges, the habit and temperament of the patient, his mode of
life, the season, and the country.
Thb Curb. — If the intemperament be cold, we must warm, but if
accompanied with humidity, we must also dry ; but if with dryness,
we must, at the same time, moisten and warm. In like mcmner,
when the intemperament is warm, we must cool ; but if dryness also
prevail, we most likewise moisten ; or if humidity, we must both
cool and dry. Where we find a sanguineous humour prevailing,
we must bleed, or use acrid clysters, then give hiera, and use mas-
ticatories ; anoint the head, by mixing with oil things of a cooling
and dessicative nature, I mean roses, myrtles, lentisk, and the like ;
and we must attend to the general system. But, if it proceed from
an over- heat and fatigue, we must apply to the head the embroca-
tion of vinegar and rose- oil ; and otherwise use a cooling and moist-
ening regimen, in all respects, and with regard to food and drink.
If earns supervene upon fatuity or oblivion, it also is to be attended
to, as formerly mentioned under the head of lethargy, where we
also stated the discrimination between these complaints.
XII. — On Vertigo.
Vbrtioo is occasioned by a cold and viscid humour seizing upon
the brain, whence the patients are ready to fall down from a very
slight cause, such as sometimes from looking at any external object
which turns round, as a wheel or top, or when they themselves
are whirled round, or when their head has been heated, by which
means the humours or spirit in it are set in motion. And some-
BOOK THIRD. 261
times it is occasioned by the anterior cavities of the brain being
compressed in perforations of the skull for fractures, in which cases
there arc violent pains. When it is a primary affection of the head,
it is preceded by strong pain in the part, by cams, and noises in the
ears ; and some have either the sense of smell or of taste impaired.
But, in those cases which arise from sympathy with, the orifice of
the stomach, heartburn accompanies and nausea follows.
Tub Cure. — Those affected with vertigo are to be roused at the on-
set, by using strong-scented things of a suitable nature, by frictionf ,
and such like ; and, during the remission, for the recovery of the
complaint, they ought first to be bled, and then purged with hienu
And, after an interval, we must use an acrid clyster of centaury » or
the decoction of colocynth. After these evacuations, we are to ap-
ply to the back part of the head cupping- instruments with scarifica-
tions, and afterwards use masticatories and sternutatories. When
there is heat in the head and noises in the ears, inasmuch as they
are occasioned by hot vapours diffused in the arteries, we must have
recourse to anteribtomy behind the ears, as will be described when
treating of surgical matters.
XIII. — On Epilepsy.
Epilepsy, being a convulsion of the whole body with impairment
of the primary energies, has its cause seated sometimes in the brain
itself, and sometimes in its cavities. This is sometimes a pituitous
and sometimes a melancholic humour. The disease also sometimes
arises from sympathy with the orifice of the stomach (as happens in
colic affections, as will be stated when treating of them) ; and some-
times it is propagated from other parts, when a cold aura ascends
to the brain, either from the leg or the fingers of the hand. It has
also been seen to proceed from the uterus in females, at the
time they were pregnant, for, after delivery, it ceased. This dis-
order attacks mostly the young, more especially infants, and after
them, boys and adults ; but, least of all, elderly persons and the
old. Its precursors are, an involuntary commotion, both of mind
and body, despondency, oblivion of accustomed things, terrifying
vision^ in dreams, headach, continued fulness of the head (especially
from acute anger), paleness of countenance, and an irregular motion
of the tongue, so ihsX some even bite it. When it proceeds A*om
the stomach, palpitation thereof goes before, with disorder and
aching pain ; and, when fasting, or during a delayed meal, they fall
into a paroxysm. When the attack comes on they suddenly 6adl
down, are convulsed, and sometimes utter inarticulate cries. The
characteristic mark of these cases is foaming at the mouth, all the
other symptoms being common to other diseases. In certain in-
stances the lurine and faeces are evacuated involuntarily, and in
some the semen also. In some cases, when the disease is very acute,
it proves fatal speedily, by the continuance of the paroxysms, or the
violence of the attack ; but it is most frequently protracted, so that.
252 PAL'LUS iJfiGINETA.
if it be not removed by tbe attainment of manhood, by purging, or
pregnancy, or, if it invade after this period of life, it for the most
part does not leave a man until death, unless removed by a suitable
cure. The following substances are used to prove epilepsy, name-
ly, tbe fumes of bitumen, or gagate-stone, or goats' horn, or the
liver of a buck-goat when eaten, or the smell of the roasted liver.
The Curb. — ^When the patient is an infant, we need not be par-
ticularly solicitous about it ; for, when its age changes to a more
bilious and drier constitution, and the diet is more prudently regu-
lated, the affection will go off spontaneously. But we must attend
to the diet not only of the infants, but likewise of their wet-nurses.
After boyhood, those that fall into the disease ought to have the
convulsed and distorted parts freely anointed, ligatures applied to
them, when they are to be stretched out ; and then the mouth is to
be opened, and one must introduce a finger or a feather, smeared
with oil of iris, in order to bring away the phlegm. We must also
rouse the senses by strong-smelling things, such as hogs-fennel,
Cyrenaic juice, bitumen, and the pitch of cedar. But after the
paroxysms, if nothing prevent, we must bleed from the arm ; and,
when the paroxysm does not abate, we must apply a sinapism to
tbe extremities, and a cupping-instrument to the hypochondria.
When after these things, no remission takes place, there can be but
little hope, and yet the physician ought boldly to force castor into
the mouth, and Cyrenaic juice, with honey and vinegar ; and the
decoction of centaury, or of colocynth, must be injected by the
anus. Those that are recovering from an epileptic attack are to
be evacuated after recovery by purging with hiera. This is the
cure of a recent and acute attack of epilepsy. We will next de-
liver the treatment of the disease when it is in a chronic state.
Wherefore the patients are to be made to persevere for a long
time in drinking cold water ; and, when setting about the cure, it
will be proper to bleed if nothing prevent ; and after an interval of
four or five days to recruit the body, and thus evacuate with a pur-
gative, more especially black hellebore, colocynth, or scammony. The
hellebore, without its medullary part, is to be pounded and strained,
and sprinkled on five or six cyathi of honied water, or it may be taken
in boiled honey with some pepper. Rejecting the seeds of the
colocynth, fill it, still retaining the medullary part, with must, and
allow to remain for a whole night ; in the morning dilute the
must, and give to drink. Or we may use the cathartic from white
hellebore. It is this : — Of cleansed bay berries, dr. viii.; of white
pepper, dr. viii. ; of alypias, dr. viii. ; of euphorbium, dr. viii. ; of
white hellebore, dr. viii. Give these things at one dose, with the
must in the colocjnith, and it will evacuate properly by vomiting.
After proper purgation let them be put into the bath, and on the
third day cup the hypochondria and back with scarifications ; and
then, stopping for a sufficient number of days, and recruiting the
body, give the hiera from colocynth ; and afterwards apply the cup-
ping-instrument to the head and nape of the neck, and the day f(^-
lowing a cataplasm consisting of bread boiled in honied water,
BOOK THIRD. 263
and pounded with bitter almonds, wild thyme, mint, calamint, or
rue. This must be done for three days. Afterwards the head is
to be shaven and rubbed with the juice of hogs-fennel dissolved in
vinegar wherein cow parsnip has been boiled ; then, after stop-
ping and recruiting the body, nine oboli of the antidote from colo-
cynth is to be given in honied water ; and, again, after an iqterval
of some days, the antidote is to be repeated, and sternutatories used.
After five or six days give castor in honied water ; then stopping
again administer a clyster of centaury and colocynth ; and after-
wards give the hiera again, and use masticatories and errhines in
order, and apply a sinapism to the head. Acrid food must be
seasonably given. Benefit may be obtained from oxymel of squills
drunk every day, and honey in which the squill has been softened,
to the amount of a spoonful. The diet should be of an incisive and
attenuant nature ; and, therefore, cappers may be frequently taken
with pickle. But they ought to abstain from flesh, pulse, and
much wine, likewise from frequent venery, baths, mustard, and
from drinking immediately after the bath, more especially of un-
diluted wine. Let them have recourse to gymnastic exercises and
friction, and the last part that is rubbed should be the head.
On thb Cure or Epilepsy from the Stomach. — Il^he disord^
is occasioned by the stomach's being primarily afiecteff/Xhe patient
inust attend to his digestion, taking about the third hour some
carefully-baked bread that has been soaked in some diluted wine,
which is slightly astringent, and of a white colour. Give to sueh
persons the medicine from aloes twice or thrice every year. " I once
knew a boy," says Galen, *' who was never seized with epilepsy
after he carried a large piece of fresh pseony appended from his neck."
Agaric is beneficial to epileptics, also hartwort, the fruit and root
of cow parsnip, and the round birthwort drunk with water. Scari-
fication of the legs frequently repeated is also of great use.
On Epilepsy proceeding from some of the Members. — ^When
the attack is threatened, and they feel a sensation in the part, whe-
ther the hand or foot, a tight ligature ought to be applied above it,
and the cure attempted during the remissions, by applying some
caustic substance to the part, such as the garden cresses QepidiumJ,
preparations from cantharides, and the like. The Julian oxymel is
also of great use to epileptics, by expelling the oflending matter
horn, the part. After those things which have been mentioned, the
theriac and natural baths have place. During their whole life, they
must particularly guard against indigestion, and be careful not to
take food before digestion has been performed ; avoid all incrassat*
ing food, too long abstinence from food, all vehement venereal
impulse, much wine, and drinking, after the bath, more especially
of diluted wine, as formerly mentioned, and likewise of old and
thick wines. They must avoid, also, all things of an acrid smell,
and such as fill the head ; must abstain from looking down stead-
fastly from a high situation, from remaining long in the bath, and
exposing the head to the heat of the sun.
254 PAULU8 iEOINETA.
XIV. — On Melancholy, Mania, and Demoniacs.
Mblancholy is a disorder of the intellect without fever, occa-
sioned mostly by a melancholic humour seizing the understanding ;
sometimes the brain being primarily affected, and sometimes it be-
ing altered by sympathy with the rest of the body. And there is
a third species called the flatulent and hypochondriac, occasioned
by inflammation of the parts in the hypochondria adjoining to the
stomachy by which sometimes noxious vapours or aurse are transmit-
ted to the brain, and sometimes part of the substance of the humour.
The common symptoms of them all are, fear, despondency, and
misanthropy ; and that they fancy themselves to be, some, brute ani-
mals, and imitate their cries; and others, earthen-vessels, and are
frightened lest they be broken. Some desire death, and others
are afraid of dying ; some laugh constantly, and others weep ; and
some believe themselves impelled by higher powers, and foretell
what is to come, as if under divine influence ; and these are, there-
fore, properly called demoniacs, or possessed persons. The peculiai^
symptoms of melancholy, from sympathy with the general system,*
are leanness, darkness, and shagginess ; the whole appearance '^
melancholic, either by nature, or acquired by anxiety, want of
sleep, the administration of noxious food, or stoppage of the
hemorrhoidal, or menstrual discharge. Melancholy, from aflfection
of the hypochondria, is indicated by indigestion, acid eructations,
heat and heaviness of them, retraction of the hypochondria, and
sometimes inflammation, especially in the beginning ; and then,
when they increase, melancholic symptoms supervene. Thes» are
relieved by digestion, or copious discharges, or flatus, or vomiting,
or eructations. When none of these S3rmptom8, or very few of
them, are present, melancholic symptoms appearing indicate that
the brain is primarily afl^cted, and for the most part from a melan-
cholic humour. When the complaint is occasioned by yellow bile,
which, by too much heat, is turned black, it will bring on the
disease called mania, which occasions ungovernable madness, so that
those affected with it will destroy persons who come near them un-
guardedly.
Thb Curb op Mblancholy. — ^Those who are subject to mdan-
choly from a primary affection of the brain are to be treated with
frequent baths, and a wholesome and humid diet, together with
suitable exhilaration of mind, without any other remedy, unless when,
from its long continuance, the offending humour is difl&cult to
evacuate, in which case we must have recourse to more powerfuL
and complicated plans of treatment. These cases are to be parge<E
from the first with dodder of thyme (epithymus), or aloes ; for, if an^
small quantity of these be taken every day, it will be of the greatest
service, and open the bowels gently. After purging, as we have
mentioned, give worm-wood, sometimes macerating and boiling*
the herb in water to the amount of two cyathi, and sometimes
diluting the juice with water, to the amount of half a dram, and
f
BOOK THIRD. 2&5
giving it frequently. Let them drink of the most acrid vinegar
before going to Bleep, and dip, for the most part, their condiments
in it before eating them. But it will be better if to the vinegar
be added squills, poley, or the slender birthwort. When you meet
in with an incipient case of the complaint, from sympathy with the
general system (as described above), and the body is firm, yoa
must, by all means, begin with phlebotomy, and after phlebotomy,
when the strength is recruited, purge downwards, with the wild
cucumber, and the composition from the black hellebore, and pro-
mote the hemorrhoidal and menstrual discharges, if the affection be
occasioned by retention of them. Diuretic remedies are likewise
jiroper, as also evacuations by perspiration. But, if the complaint
arise from disorder of the hypochondria, we must attend to them,
and foment them with a decoction of rue, dill, wormwood, penny-
royal, the seed of the chaste-tree, and of the fruit of the bay-tree ;
for, these soothe the pain and diminish flatulence. Tliey may be
boiled in oil and applied ; and the cataplasms of them ought to con-
tain the remedies for flatulence, namely, parsley, or anise, or cumin ;
and it will not be improper to add cyperus, iris, and frankincense, to
the cataplasms. These things are to be allowed to remain in ge-
neral, even during the day, and whether the patient eat or fast ; and,
^hen taken away, apply some other protection, such as a broad
piece of wool. Use dry- cupping for flatulence, and cupping with
scarifications for pains and inflammations. While directing your
attention to the cure, you must not forget mustard, and apply acrid
•smegmata and calefacient plasters to the back and belly. In chronic
cases, the most powerful remedy is evacuation, by vomiting with
Lellebore. The diet for all melancholies should be wholesome,
and moderately moistening ; abstaining from beef, roe's flesh, dried
lentil, cabbages, snails, thick and dark-coloured wines, and, in a
^word, from whatever things engender black bile.
Ths Curb or Mania. — Persons affected with mania are to be
^treated like melancholies ; and, in particular, we must apply to the
^ead rose-oil, or rose- oil with vinegar, and purge with the bitter
^mtidote called hiera, having previously bled them ; and we must
TLse leeches to the head. But nothing is of such service as horse-
:iennel, either the root or seed drunk in water. A dram of the root
«f bryony with water may be taken every day. If the maniacs will
:i&ot be persuaded to take the purgative medicines, they must be
'xnixed with fheir food, in a concealed manner, such as with
Tnouthfnls of meat, or dried figs, or dates, or else with their drink.
lEut, above all things, they must be secured in bed, so that they
^may not be able to injure themselves, or those who approach them ;
or swung within a wicker basket in a small couch suspended from
^n high.
XV. — On Incubus^ or Night-mare,
SoMB say that this disorder is called ephialtes in Greek from the
256 PAULUS iSOINETA.
name of a man, or from those in it fancying as if one leaped upon
them. But Themison, in the Tenth Book of his Epistles, calls it
ptugaleon, from a Greek word signifying suffocation. It attadu
persons after a surfeit, and who are labouring under protracted in-
digestion. Persons suffering an attack experience incapability of
motion, a torpid sensation in their sleep, a sense of sufibcation, and
oppression, as if from one pressing them down ; they are unable to
cry out, or utter inarticulate sounds. Some imagine often that
they even hear the person who is going to press them down, that
he offers lustful violence to them, but flies when they attempt to
grasp him with their fingers. The evil must be guarded against at
the commencement ; for, when it continues long, and attadcs every
night, it is the forerunner of some serious disease, such as apoplexy,
mania, or epilepsy, when the exciting cause is determined to the
head ; for such as persons affected with epilepsy are, during the
day, those labouring under night-mare are in their sleep. We must
evacuate the patient's general system by opening a vein and adminis-
tering purgatives. Black hellebore is especially serviceable to them
when given to the amount of a dram, if three oboli of scammony, and
some of the aromatics, such as anise, wild carrot, and Macedonian
parsley be mixed with it. The composition called hiera, from wild
gourd, is also of great service ; it is the hiera of Ruffiis. The diet
should be light, and they ought to avoid every thing that is flatu-
lent. They are benefited also by the fruit of pseony : fifteen of the
black grains of which may be pounded with water and drunk fre-
quently.
XVI. — On Lycaoriy or Lycanthropia.
Those labouring under lycanthropia go out during the night
imitating wolves in all things, and lingering about sepulchres until
morning. You may recognise such persons by these marks : — they
are pale, their vision feeble, their eyes dry, tongue very dry, and
the flow of the saliva stopped ; but they are thirsty, and their legs
have incurable ulcerations from frequent falls. Such are the mai^ks
of the disease. You must know that lycanthropia is a species of
melancholy which you may cure at the time of the attack, by open*
ing a vein and abstracting blood to fainting, and dieting the patient
with wholesome food. Let him use baths of sweet water, and th^
milk-whey for three days, and purging with the hiera from colo-
cynth twice or thrice. After the purgings, use the theriac of vipers^^
and administer those things mentioned for the cure of melancholy.
When the disease is already formed, use soporific embrocations,
rub the nostrils with opium when they are going to rest.
XVII. — On Love-sick Persons.
There is nothing improper in joining love to the affectioDS
BOOK TIIIRD. 257
the brain, Binoe it consisU of certain cares. For care is a pawion
of the aoal occasioned by the reason being in a state of labonoas
emotion. The following symptoms attend lovers : — ^Their eyes are
hollow, and do not shed tears, but appear as if overflowing with
gladness, thebr eye- lids are moved rapidly ; and even, when none of
the other parts of the body are collapsed, these parts are alwaya so
aflected in lovers. There is no pulse peculiar to lovers, as some
have supposed, but it is the same as that of persons labouring under
c^re. When they call to recollection the beloved object, either
ftrom seeing or hearing, and more especially if this occur suddenly,
then. the pulse undergoes a change from the disorder of the soul,
and, therefore, it does not preserve its natural equability or order.
Such persons, therefore, being desponding and sleepless, some phy*
sicians, not understanding their affection, have wasted them by pro-
hibiting .baths, and enjoining quietude, and a spare diet ; but
wiser ones, recognising the lover, direct his attention to baths,
drinking of wine, gestation, spectacles, and amusing fables. Some
must also be attacked with fear ; for, while they think of nothing but
love, the affection is difficult to remove. Wlierefore, they ought
also to be roused to emulation with regard to the objects of their
peculiar interest in life ; and, upon the whole, their understanding
should be diverted to other concerns.
XVIII.T— 0» Apoplexy and Hemiplegia^ or Paralysis,
Whbn the common origin of the nerves is affected, and from it
all the other parts of the body have lost their motion and sensibility,
the affection is called apoplexy, by which the primary energies are
impaired ; but, if ihe obstruction is in either side, it is called hemi-
plegia and paralysis ; and, if the injury is seated in any one part, it is
called an afiection of that part, and hence Hippocrates says : — " His
leg was seized with apoplexy."
Wherefore, in apoplectics, the respiration remains small. When,
then, it is greatly changed from the natural action, it will induce a
strong affection, and when but little, a weak one. Respiration is xA
the worst kind when it intermits, or is performed with great exer-^
tion. The affection arises suddenly from a cold phlegm obstructing
the most important cavities of the brain. Whenever the whole ori-
gin of the spinal marrow is affected, all the parts below the face be-
come paralyzed, whilst it remains unaffected, because the parts
there derive sensibility and motion from the brain ; but, if one-half
only be affected, then is there a paraplegia of these parts, that is to
say, a partial paralysis. If the sense of smell is affected, this arises
from the anterior cavities of the brain having contracted the intern-
perament, or from the pores of the ethmoid bones being obstructed.
Wherefore, apoplectics lie speechless, motionless, and insensible,
having no fever. The precursors of this affection are, sudden and
acute pain of the head, distention of the jugular veins, vertigo,
flashes, as it were, of light, in the eyes, an inordinate coldness of
8
258 PAULU8 iSGINBTA.
the extremities, palpitation and difficult motion of the whole body,
and grinding of the teeth in sleep. Their uride is in small quantity,
of a green-grey or a black colour, and containing a farinaceous sedi-
ment. The affection occurs in old age to those of a phlegmatic
temperament, and who use a diet of this nature. If it occur in youth
and in the season of summer, it indicates a strong exciting cause.
The Curb of Apoplexy, and Hbmiplboia, or PARALTSit.— -
Apoplexy is an affection which is never, or but rarely cured, for it
threatens instant death ; and, if it be removed, it commonly leaves a
paralysis of some part of the body. Wherefore, those persons who
admit of being cured should be immediately bled, and, if there be
any remission of the disorder, the operation should be repeated on
the same or the following day. The belly should be opened by a
stimulating clyster, made by mixing salt water and honey. Then let
the whole body be rubbed with plenty of sulphurated oil, but the
head with the oil of camomile, or of dill in which cow-parsnip or
calamint has been boiled. Inject honied water, and apply strong-
scented things, such as opopanax, sagapene, galbanum, or castor,
to the nose. It may be necessary to open the mouth forcibly, and
introduce a finger or feather dipped in oil to remove the matters
sticking there. Anoint the anus with applications for promoting
the discharge of flatus. Give honied water and oxymel to drink,
and use masticatories prepared by boiling thyme, or marjoram, in
vinegar. When there is a remission of the complaint, we are to
have recourse to tender, diffusible, and succulent food. When loss
of speech continues, if the strength permit, we are to apply to the
back part of the head a cupping-instrument with scarificators, and,
if admissible, it should be applied to the hypochondria also* Let
them afterwards be carried about in a chair, or couch, or suspended
bed, and have recourse frequently to sternutatories and masticatories.
After the fourteenth day, we may bring them back to the other
kinds of gestation, attend to their speech, give old apomel with
pieces of bread or alica, and afterwards a small quantity of hiera»
After the twenty-first day, we may lead them to the bath, give
them old wine to drink ; and otherwise we must promote recovery
by sprinkling them with warm water, by baths, and rubbing witlt
unguents. If possible, let them reside in places by the sea-coast.
The Curb of Paresis, or Resolution. — If there be paralysis of
all or of certain members, without injury of the primary energies,
we must first evacuate the offending humour, whatever it be, and
then give hiera, and a certain portion of castor, beginning with half
a dram, along with some honey and warm water in which it baa
been dissolved, either alone, or with the addition of half a scrapie
of pepper ; then, after an interval of four days, we may give a whole-
dram, and afterwards one and a half, then two and three. After a&
interval of the same number of days, we may give four drams, if
the patient be able to take so much, adding one spoonful of honey.
To the part we may apply some of the discutient remedies, alon^
with rubefacients, adding to them some castor, or pepper, or pelli*
tory, or rosemary, or euphorbium; and, in addition to these,. we.
BOOK THIRD. 250
maykaye reooune to embroottions with oil of rue, or Sicyoiiim» or
old oil. The food oagbt to be farinaceous, taken in a supping ttstet
of easy digestion, and not excrementitious. Let capping-iiistm-
ments be applied to the a£fected parts separately, if there be many
of them, but to one if there be few. After cupping, apply oata«
plasma containing pitch, rosin, or manna. A most suitaUe a]^i-
cation consists of calamint, flea-bane, and nitre boiled along with
HiugpRTort, and some water is to be added, which is to be evaporated
daring the boiling. The belly is to be again opened by means (k aloea,
polypody, soammony, or the colocynth pottage. Fatty inunctions
are to be made with old oil in which squill has been kept for forty
days in the son ; or, if it be not at hand, you may boil in oil two
ounces of squill, and anoint with it ; or the seed of rosemary may
be prepared in like manner, but an ounce of wax must be added,
that it may not be too liquid. But, if you add of galbanum, of
castor, of euphorbium, of adarce, and of nitre, of each, oz. ss. it
will be a more potent remedy. The herb crow-foot, boiled in the
oil, and preserved in the sun, is also an excellent application. Cas-
tor to the amount of a dram, and opoponax swallowed to the size of
« bean, will make suitable potions. But sagapene taken to the size
of a tare in honied water, and castor with opoponax, and the Cyre-
naie juice to the size of a millet, are admirable remedies. The an-
tidote from the three peppers is also beneficial. We may likewise
use heating restoratives (acopa), and masticatories. After the four-
teenth day, we may give more copious food ; and, when much bene-
£t is derived, we may lead to the bath. After the thirtieth, it will
l>e necessary to apply a dropax, use the bath, and afterwards put on
« cataplasm of mustard, taking care in those cases in which both
motion and sensibility are lost, lest from want of feeling they be al-
lowed to bum too much. Where sensibility remains, rubefacients
^«nly are to be used. After it swells, we ought to lead to the bath,
<«nd cure with simple cerates. They ought to take the emetic after
m meal, and that from radishes. They should be carried about in a
«hair, or in a car drawn by the hand, or in one drawn with a yoke.
Otherwise, let them be put into one of the natural baths. A desic-
^cative diet, spare drink, and friction, will be proper. Let them,
therefore, eat dry food, and struggle against thirst as much as
]N>ssible.
On Paralysis with Rblaxation or Distension. — Since para-
lyzed parts are either contracted or relaxed, and this proceeds either
'mum. plethora or emptiness, it will be necessary to attend to this,
mtA sometimes abstract blood, and sometimes not. — Again, to re-
laxed parts we must mix astringents with the relaxing remedies,
«od use intense friction ; but for the contrary state we must use
vdazing remedies only, along with gentle friction. For the relaxed
limbs, let the oil used for friction have a little nitre and dried lees
of wine pounded in it. Let hot water also be strongly poured upon
tliem, especially sea-water, in which have been boiled bay-berries,
yt the ^oots of the chaste-tree, or maijoram, or the like. If it is
a the summer season, let them also swim in the sea. But rubefa-
s 2
260 PAULUS ^QINETA.
cients are particularly applicable to them, and, therefore, the parts
may be whipped with rods, or nettle branches ; but, if the paralysis
remain, the relaxed skin between the joints is to be drawn up, and
transfixed with small and slender burning-irons. To contracted
limbs it is proper to apply constantly a calefacient plaister.
On Paralysis in particular Parts. — Paralysis occasioned by
the division of a nerve is incurable ; but, when occasioned by an in-
temperament, or a certain humour, it is relieved by the common
remedies already- mentioned ; but there are certain particular reme-
dies applicable to each of them which we shall describe below.
Whereifore, in cynic spasms, the jaw is to be reduced to the oppo-
site side by means of a muzzle. Detraction of blood from the ves-
sels below the tongue will likewise be proper, as also cupping-
iDStruments applied along the first vertebra, with masticatories, and
purgatives administered by an instrument inserted into the nose.
It is necessary to know, that the jaw whioh appears to be distorted
is not the one which is paralyzed, but the opposite one. When the
organ of deglutition is paralyzed, cupping-instruments must be
applied to the chin, and we must use the liniments made of castor,
sagapene, and the Parthic juice. Acrid gargles are also beneficial.
When the tongue is paralyzed, we must open its veins, apply a cup-
ping-instrument to the chin, and use masticatories of mustard, and
exercise the tongue. When the organs of speech are paralyzed,
apply the remedies to the chest, practise retention of the breath,
and vociferation. When the eye-brows are affected, anointing of
the eye-lids in like manner is of great use, and, at last, the opera«
tion by suture called anarrhaph^. When the bladder is paralyzed,
there is either retention of urine or an involuntary discharge of it*
The remedies are to be applied to the bottom of the belly and peri-
nseum, and clysters injected by the anus, consisting of oil of rue,
or Sicyonian oil, with butter and castor, galbanum, opoponax, or
the juice of laser-wort. And these things, if injected into the
bladder by the penis, will be of great service, or prove sufficient of
themselves. Clysters of centaury and colocynth, along with Si-
cyonian oil, are also beneficial ; and diuretics may be drunk with
advantage, and castor taken in like manner. But, above all things,
we must have recourse to the catheter when the patients cannot
make water, and get them to sit in hot-baths of a relaxing nature,
and use emollient cataplasms. When the urine flows involuntarily,
we must treat them upon the astringent plan with tonic remedies,
and make them use dry food and cold drink. During convalescence,
they ought to use rubefacients, and natural baths in a cold state.
Cases occurring from a wound of the spine, from a fall and disloca-
tion of a vertebra, if there be a concurrence of fatal symptoms, it is
impossible to remedy. If the penis is paralyzed, we must apply
the remedies recommended for the bladder, to the same parts, and
also to the groin ; and medicines which excite to erections ought
also to be used. Milk, cheese, and the other cakes, are improper,
likewise lettuces and the other pot-herbs. When the rectum is
BOOK THIRD. 361
paralyzed, in which case the fseces are either discharged involoa-
tarily, or retained, the same remedies must be ased, and clysters
are to be administered sometimes of an astringent nature, such as
the decoction of cypress, lentisk, or bramble ; and sometimes emol-
lient, such as the fat of swine and geese, and the oil of mallows ;
and sometimes stimulating, such as salt-water, the decoction of colo»
cynth, or the like. Nothing contributes so much to motion as va-
riety of exercise with the lever. If they complain of a sense of cold,
the restorative plaister of euphorbium, mixed with oil, may be used
for a clyster. But, along with the ordinary treatment, the para •
lyzed limbs should be bent, rubbed, and stretched in the manner
described ; for our greatest dependence is upon friction.
On Paralysis Supervbnino upon Cholic Disease. — In our
times, a cholic complaint has prevailed, in which those who are
about to recover are seized with complete loss of motion in their
limbs, but the sense of touch remains uninjured, there being a cri-
tical translation of the disease from the inner parts. Hence, in
many cases, the motion has returned spontaneously in process of
time. Those of more difficult cure were remedied by using the
more simple liniments formerly described. The acopa made of
poplar and of the fir were found to be excellent applications; and
many were greatly benefited by tonic and moderately cooling appli-
cations.
XIX. — On Convulsions, or Spasms.
Thb consideration of spasms naturally follows that of paralysis^
because botli are affections of the nerves ; and, for the same reason^
We shall next treat of tremors. When, therefore, spasms come on
^t tlie commencement of the complaint, or nearly so, and are pro-
tracted, they have their origin in plethora ; but, when they super-
vene after copious sweatings, vomitings, discharges from the bowels,
Ixeznorrhages, watchfulness, hunger, or much and violent exercise,
tiliey proceed from depletion. If they suddenly attack a person in
Health, they must necessarily proceed from plethora. But, when in
H.rdent fevers the nerves and whole body are dried, and then spasms
oome on owing to the dryness, this is one of the worst possible
Oases, and is almost incurable. Wherefore, we must, in the first
I^lace, bind the limbs which undergo contractions, and resist their
inordinate motions, and rub them with oil of rue, Sicyonian or old
oil, or the like ; and the patients must take Propomata of honied
^ater. In cases from depletion, warm oil, or oil and water, are to
l>e x>oured upon the patients, and, if nothing contra-indicate, they
teay be put into a bath. We may use a tepid hip-bath with oil, and
the genflest friction. For food, they must take spoon-meats of chon-
drus* and alica ; and we may allow them a thin watery wine of easy
diffusion if they have no fever. Then we must use the juice of
ptisan and promote sleep. Spasms occasioned by plethora, or in-
flammation, we may cure by diminishing the fulness, and removing
262 PAUJLUB iCGINBTA.
the inflammation by euitable remedies. Spasms come on also du-
ring the agitations of violent vomitings, which (iases are benefited
by drinking infusions of the root of cotton- thistle, or of the white
thorn, or of the Egyptian thorn ; but some give the juice of the
slender centaury to drink when the convulsions arise from plethora;
and one should not only drink it, but rub the skin externally with
castor and Sicyonian oil. If they do not cease, cupping- instrumenta*
with scariflcations, should be applied ; when the legs are affected,
along the ischium and the last vertebra ; and, when the arms vte
convulsed, to the back, to its first vertebra, and the one above the
shoulder. When the rest of the body is not affected, but one of the
lips, eye-brows, or tongue, is contracted, the symptom is to be
reckoned dangerous, and alarming, although the parts affected be
but small in size. Wherefore you must abstract blood from the
hind-head, from over the first vertebrae*
XX. — On Teiamts and Us Varieties*
Tbtanus also, being a spasm, takes place from the muscles of the
body, and more particularly those about the spine, beii^ as it were
congealed by a cold humour, both within and without ; and hence
they are incapable of bending themselves. But, when the parts of
the body are stretched forwards, the afifection is called emprostho-
tonos ; when backwards, opisthotonos ; and, when the parts are
stretched equally both ways, the affection is called tetanus. Pelops
savs, that these affections consist of a tension and contraction of
the muscles and perves about the neck, by which we stoop, nod» and
turn the head ; that, if the affection be seated in the posterior mos^
cles of the neck, the disease is, from this circumstance, called opis-
thotonos ; when in the anterior, emprosthotonos ; and, if both are
affected, tetanus. The cause, he says, is a pneuma^ and thidk and
nebulous air filling the muscles. He says that it is very cold and
congealed, and that this is the cause of the difficulty of motion.; and
that, therefore, dry fomentations, and not moist, are most suitable
to them. And these are the varieties of tetanus. But^ he adds,
the cure of all is the same, and does not diange with the varietiee.
Wherefore, the most certain remedy for them all is» a fever snper-
vening, when there was none at the commencements The symp*
toms are, a moaning respiration, pulse rare and small ; and 80Bie*>
times there is a sardonic laugh ; the face is red, and their eyes
appear larger than natural ; their urine is eithel* wholly suppressed^
or it resembles common water, or is somewhat bloody, and contains
certain bubbles ; the belly is dried up ; they cannot sleep ; And often*
from the violence of the spasms, they are in danger of falling out
of their beds; they sometimes have singultus, and pains in the
bead, or between the shoulders and loins ; and some have tremors.
The disease is occasioned sometimes, though rarely, by fatigue, by
lying upon the ground, lifting of weights, a fall, a wound, a bum.
BOOK TH1BJ>. 268
and a blow« or any other thing which can injure the nerves. Tlie
disease is to be cured like convulsions from depletion.
Thb Curb or thb Varibties or Tbtanus. — In treating tetanio
spasms, we must begin with phlebotomy, and wrapping the parts
in wool which has been dipped in oil, namely, the Sicyonian and
castor with old oil, or a broad bladder coAtaining hot oil may be
applied to the tendons. Cupping-instruments, with scarifications,
are to be applied ; for dry cupping is hurtful. They may be applied
to the neck, both sides of the spine, the muscular parts of the breast,
the hypochondria, and the region of the bladder or kidneys. We
must not be sparing of the detraction of blood, nor yet take away
too much at a time, but at intervals. The sweats should be
absorbed by the wool dipped in oil, lest the patient happen to
catch oold« If the attack of tetanus continue long, the patient
must be put into a hip-bath of oil twice a-day, but not allowed to
remain long in it; for, of all applications, the bath of oil is the
most debilitating. Let him drink tepid hydromel boiled to the one-
half ; and the robust may take a dram of opoponax, or, if not so
much, three oboli, or at least one obolus, if we are afraid of its
proving injurious to the stomach. We must also give gum ammo*
niac ; or, the cyrenaic juice to the size of a tare, made up with
Well-boiled honey, may be swallowed. Two spoonfuls of the root
of laser-wort may be given in three cyathi of honied- water, or in
its decoction ; or one dram of myrrh in honied-water, or the decoc-
tion of hyssop. But the least dangerous and most effectual remedy
is castor, to the extent of two or three spoonfuls in divided doses.
And it will do no harm if you give it after a meal ; but the drink
and the other things should be taken slowly and by degrees ; for, if
swallowed with difficulty, the drink regurgitates at tiie nose, the
violent agitations of which bring on convulsions. The anus should
be smeared with oil of rue, along with opoponax, and the same
things Bte to be given in a clyster. The affusion of cold water
being, as Hippocrates says, exceedingly hazardous, and, for that
reason, I suppose, rejected by succeeding authorities, we too are
disposed to condemn.
A LiNiMBNT. — Of nard (valerian), one sextarius ; of wax, oz. ii. ;
of malabathrum, of amomum, of storax, and of mastich, of each,
oz. i. ; of castor, of adarce, of euphorbium, of pepper, of each, oz. i. ;
of spikenard, of opobalsam, of each, oz. i.
A Potion for Opisthotonos. — Of the root of panacea, of white
pepper, of costus, of myrrh, of poppy juice, equal parts. Give to
the size of the vetch called aracus at bed-time. It is also a remedy
for orthopnoea. Let the diet be attenuant, of easy diffusion, and by
Qo means excrementitious.
XXI. — On Tremblings.
Tremblino is generally occasioned by a weakness of the nerves
Cold age is a proof of this) ; but there are many particular causes
364 PAULU8 iEOlNETA.
which occasion it ; for it arises from a cold intemperament, from
drinking co]d water, more especially if taken unseasonably duriDg
a fever, also from a redundance of cold and viscid humours, and
from the too liberal use of wine. Those, therefore, who have
tremblings from any obvious error in regimen must abstain from
the things which prove injurious to them. And, again, when the
tremor remains during fevers, we must first rub the body with
Sabine oil ; but in the remissions of the attacks with old, or Sicy-
onian oil. Let the extremities, after being anointed, be wrapped
in soft wool, and then let cupping-instruments be applied along the
spine from the first vertebra to the loins ; these parts, together with
the hypochondria, being previously covered over with raw barley-
meal. Let them also be wrapped with wool out of old, or Sicyonian
oil. But, if the fever continue, every alternate day let tbera be
put into a hip-bath of oil or oil and water, and use soft frictions, fiat,
if the afiection be prolonged, and cold is suspected, they should take
a propoma, or sweet potion of honied- water and castor, and be car*
ried about in warm places ; and we ought to give them food of easy
distribution, at first spoon-rocats, and afterwards such fowls and
fishes as have tender flesh. When the fever is gone, they must be
washed, avoiding the cold bath and wine. But» if there be a ful-
ness of thick and viscid humours, we must use remedies of an in-
cisive and attenuant nature. They are these : — Of the shoots oime,
of cow-parsnip, as much as can be contained in three fingers ; of cas-
tor, of nitre, of each, two oboli. Give every day one spoonful with
oxymel, for three days while fasting ; or, of panacea and pepper^ five
grains ; take in a draught of a cyathus of honied- water. The follow-
ing simple things in proportions relieve tremors : — Castor, the brain
of a hare eaten, the decoction of the root of marsh-mallows, of the
leaves of water- plantain, dr. iv. in honied water, hemp agrimony
with water. When the cold prevails, we may use the liniment of
Zosimus, and the restoratives, liniments, and rubefacients described
above for paralysis, also exercises and frictions. Those who have
tremblings from drinking wine must abstain from wine altogether,
until a complete cure take place.
XXIL — On Diseases of the Eye^ and first of Pain. — From
Galen.
When violent pains in the eyes take place, consider from what
afiection the eye happens to be pained in the inflammations; for they
are either occasioned by the pungency of an acrid defluxion, or from
the coats being over-filled and stretched, or from tht distension of
thick humours or of flatulent spirits. When the pains proceed from
pungency, they are to be cured by evacuating with purgatives, and
by injecting into the eye the white of an t^g. When the inflam-
mation is concocted, if the body be free of impurities, the most be-
fitting remedies are baths. Inflammations from plethora are to be
cured by the detraction of blood, purging the belly, and applying
BOOK THIRD. 265
friction to the ioferior extremities. Those from distension are to be
cored, by first evacuating the whole body, then by occasioning a
revulsion downwards of the humours, and afterwards by using topi«
cal applications of a discutient nature. The eyes must be fomented,
and the decoction of fenu-greek poured into them. When the
vessels of the eye are distended with thick blood, while there is no
plethoric diathesis in the general system, the patient must drink
wine which has the power of heating, evacuating, and removing
obstructions.
On Disordbr of ths Etb, ANn particularlt or Ophthalmt.<»-
Disorder of the eye is a wateriness and heat of it, with preternatural
redness, not occasioned by any cause within the body, but by some
external one, such as the sun, smoke, dust, or the wind ; wherefore
it is soon dispelled when the cause is removed. And ophthalmy is
a marked disorder, which may be occasioned not only by an ex-
ternal cause, but also without any obvious one, and remains nntil
the third, fourth, or fifth day. It is best cured by avoiding
every external exciting cause, by spare diet, drinking water, walk*
ing, and by opening the belly.
On Inflammation — When inflammation remains in the eyes
after evacuation of the general system, we may use ointments
for di$>pe]ling the rheum, and soothing the irritation, such as the
collyrium of Nilus made from roses, the Chiac, or the collyrium
from nard. When the tunica adnata is inflamed, we may use the
collyria called Monhemera, injecting them into the eye with the
white of an eg^. Next day, if the inflammation be not aggravated,
we may anoint them with the collyrium of nard, and use a fomen-
tation of the decoction of melilot and fenu-greek. When the
humour which occasions the ophthalmy is thick, we may use medi-
cines whieh are neither obstruents nor incrassants, but which, on
the contrary, will dissipate, dilute, and evacuate the humours, such
as the Chiac collyrium. But, if the humours are impacted in the
head, we may fix a cupping-instrument to the hind-head, or scarify,
or apply leeches to the forehead, near the eye afiected. We must
use cataplasms of pure bread soaked in water, with a little rose-
oil, or polenta boiled in the decoction of poppy heads also with rose-
oil. We may also use a more efficacious cataplasm from saflron,
melilot, the fleshy parts of dates, the tender leaves of coriander,
eggs, and roasted wheat and crumbs of bread macerated in rob,
with a small quantity of rose-oil, . pounded in the decoction of
poppy heads. We mix also the seed of the poppy as an anodyne.
If compelled by the severity of the pain, we must add a little opium ;
bat, unless the pain be very violent, we must abstain from all nar-
cotics. If the inflammation be moderate, apply aloes by itself, or
rub it in with water or the white of an egg. In order tibat the re-
medy may be ready for use, take of saffron, dr. vi. ; of aloes, dr.
xvi. ; of ^um, dr. ix. mix with rain water, and make a coll3rrium.
And the saflFron collyria, as they are called, are proper for the com-
mencement of ophthalmies. In those cases in which there is an eede-
matous and white swelling about the eye> brows and tunica adnata.
266 PAUL.US ^QIN£TA.
without injury of the coats, the best applications are those called
liquid coilyria, prepared from saffron, copperas, and honey. And
this one is excellent.
A Liquid Anodtnb Colltrium. — Of the melanteria nsed by
tanners, of Attic honey, of the juice of fenu-greek, equal parts.
Boil to the thickness of honey, and touch the two angles of the
eye with it, by means of the rounded extremity of a specillum or
probe.
For a Copious Dsfluxion. — For defluxions of humours, in the
commencement abstinence from food is proper, and the drinking
of water, and most especially abstinence iirom venery ; the belly
should be opened^ and the face washed with a watery oxycrate, if
the defluxion be of *a hot nature ; but, if otherwise, the forehead
and eye-brows may be anointed with copperas and honey. Some
dissolve the copperas in water, and direct to bathe with it. In de-
fluxions without inflammation, or with inflammation, but so that
the aflection is seated above the skull, we must use agglutinative
applications to the forehead, either simple ones, such as green "vine
leaves, or the juice of the bramble, or of purslain, or of quincea
with some fine polenta, or with gall levigated in wine, or with fine
polenta, or hemlock, or flea- wort with water, or night-shade, or
snails with their shells pounded, and applied from temple to temple,
and, in a word, with things of an astringent and cooling nature, or
with the following compound applications: — ^Wheat flour« and
myrrh, or ^nkincense, with the white of an egg, may be rubbed in ;
or, Samian earth with myrrh and manna, in like manner, with the
white of an egg ; but, in colder defluxions> of native salphnr> of
bitumen, of pitch, of colophonian rosin, of each, dr. ii. ; also the
trochisk of Musa, that called Aster, and the like, are suitable repel-
lents. And the theriac, mixed with an astringent wine, and rubbed
on the forehead, stops cold defluxions, and may be dmnk with
great advantage. Over the eye apply wool, or a small rag wet in
the white of an egg ; and new-made cheese, in like manner, when
applied to the eye, restrains acrid defluxions in particular ; also the
astringent collyria, when rubbed in or injected into the eye in a
watery state, do the same thing. But, if the humour be deep-seated
and below the ekull, and if fixed there for a length of time, after
the general evacuations use errhines and masticatories, shaving the
heady and applying rubefacients to it. But to these must be joined
the surgical operations for the head, namely, angiology, arterioto-
my, hypospathismus, and periscyphismus, with burning at the vertex
down to the bone. But cupping-instruments with scarifications ap-
plied to the hind-head will produce a revulsion of the defluxion.
The symptoms of defluxions external to the skull are, distension of
the vessels of the forehead and temples, forming as it were a band
to the head, and the complaint being remedied by agglutinative ap-
plications of a desiccant nature. When these symptoms are not
present, the defluxion being of long duration, and sometimes exas-
perated by sternutatories, the humour is to be supposed seated be-
low the skull.
BOOK THIRD. 367
On CuBMosis. — We call the disease chemosis, when both the eye-
lids are everted in consequeace of a violent inflammation, so that
the eyes are scarcely covered by them, and the white of the eye is
elevated above the black, is red, and occupies a large portion of the
black. We must cure it by phlebotomy, purging, the white col-
lyrium of roses, and the spodiac, with milk, or the white of an egg,
and we may anoint the eyelids, temples, and forehead with the same,
and have recourse to paregoric fomentations and cataplasms. When
the inflammation begins to remit, we may rub m the more acrid ap-
plications, such as.the green one ^m roses.
On Htposphaoma ANn Emphvsbma. — ^Hyposphagma is a rupture
of the veins of the tunica adnata, occasioned most frequently by a
blow. Bathe the eyes with the blood of the wood-pigeon, or of the
common pigeon, or the warm milk of a woman in which a little
frankincense has been triturated, and inject brine, more particularly
that from Cappodocian salts, and use a fomentation from the decoc-
tion of hyssop. Swellings about the eyes ^m blows are remedied
by repeated fomentations with oxyorate, or a sponge out of oxycrate
may be iqpplied to them, or a liniment may be used, consisting of
eqiud parts of burnt lapis specularis, and pigeon's dung, triturated
with wine or vinegar. Or a cataplasm may be applied of new
cheese, or of the rind of radishes, or of dried grapes without the
stonea* Each of these is to be mixed with oxycrate or honied water.
The same remedies apply also to emphysema.
On Pburibnt Emphysbma and Psorophthalmia. — Emphysema,
is an cedematous swdling of the eye-lids ; but psorophthalmia is a
scalMous eruption of the eye-lids attended with pruritus, arising from
a saltish and nitrous humour. They are remedied by oxycrate, the
decoction of lentils, and a fomentation of roses. The following is
a liquid oollyrinm :— Of copper, dr. vi. ; of calcined misy, and myrrh,
of each, dr. iii. ; of saflron. dr. i. ss. ; of pepper, dr. i. ; of Chian
wine, and Cretan sweet wine, of each, 1^ cyathus ; boil to the thick-
ness of honey. This is the coUyrium of Erasistratus called Pan-
du-estos, which applies to cynanche, ulcers in the mouth, and on the
privy parts, and to the earache. They are to be rubbed with oil
into the patient's eye-brows when he is going to sleep. Acid»
saltish, and acrid things are to be abstained from.
On Sclbrophthalmia and Xbrophthalmia. — Sclerophthalmia
is a hardness of the eye with difficulty of motion, pain, and redness,
without wateriness. For this, the eyes are to be fomented frequently
with spcmges out of hot water ; and at bed time the white of an
egg with rose-oil, or the fat of geese, may be applied to the eye-lids.
Let them avoid every thing of a cooling and hardening nature ; let
the head be covered askd anointed, and the belly kept open. Xer-
<^hthalmia is a pruriginous aflection of the eyes without rheum.
It is to be cured by baths> unguents, and a wholesome diet. Ap-
plications of an acrid nature are suitable to both, as they promote
^ flow of tears, by which the hardness will be softened, and the dry-
i^esB rendered more humid. Such are the Panchrestos of EIrasistratus,
and those called Dicenteton and Stratioticum.
268 PAULVS /GGINETA.
On Ectropion, or Eversion of the Eye-lids. — ^This complaint
is an eversion of the eye-lid, occasioned either by a scar or fun-
gous flesh. When it is occasioned by fungous flesh, and is of
long duration, bum scraped verdigris, pulverise it and apply, or
use burned lead washed with sulphur vivum, or apply both in equal
parts, namely, the verdigris and the lead. Ectropion from a
cicatrix, if at all remediable, must be cured by a surgical opera-
tion.
On iEoiLOPs AND Anchilops. — iEgilopsis an aposteme between
the great canthus of the eye and the nose, which, breaking and being
neglected, ends in a fistula that extends to the bone. Before the
aposteme breaks out into an ulcer, it is called anchilops. A very
good application is horned-poppy and saffi'on, applied with the juice
of perdicias (polygonum maritimum ?). They must be frequently
changed, and it will not turn to pus. Another : — Alica, boiled in vine-
gar and properly triturated, not only cures the disease at the com-
mencement, but, after suppuration, it bursts the abscess, and pene-
trates to the bone. By using it, you may cure not only segilops,
but anchilops. Another : — Garden me, levigated and boiled with
protostactos and applied, answers excellently for eegilops, penetrates
to the bone, stimulating at first, but afterwards not so ; and, what
is wonderful, it does not leave an ngly scar. Another : — Pulverise
snails with their shells and apply them ; and sometimes aloes or
mjrrrh may be added before the eegilops is converted to pas ; and
after the abscess bursts it dries it np.
On Trachoma. — ^Trachoma is a roughness of the inner surfiBice
of the eye-lid, an intense degree of which has the appearance of in*
cisures, and is called sycosis. When it becomes chronic and cal-
lous, it is called tylosis. We must use coll3nriums for it, namely,
the one from wine, and that prepared irom the two stones ; or, the
eye-lid may be rubbed with the blood-stone itself (haematites),
much washed in water. But the collyrium called Harmation, widi
a little of the Cycnarius, or the saflron collyrium, answer well with
these, and with cases of psorophthalmia without ulceration, when
rubbed upon the everted eye-lid. But, if the callus be hard, and do
not yield to these things, we must turn the eye-lid out, and rub it
down with pumice stone, or the shell of the cuttle-fish, or fig-leaves,
or by the surgical instrument called blepharoxyston.
On Chalazion. — Chalazion is a concretion of indolent humours
in the eye-lid, for which pound ammoniac with vinegar, and anoint
along with galbanum. It, likewise, has a good efiect when joined
with cerate and turpentine.
On Hordeolum, or Stye. — Hordeolum is a small oblong apos-
teme on the tarsus of the eye-lid. We may foment it with white
wax ; or, throwing away the head of a fly, we may rub the part
with the rest of its body ; or foment with the decoction of barley.
For Lice in the Eye-brows. — Having first cleared away the
pediculi, wash the part with tepid sea-water, and use the under-
mentioned application to the tarsus : — Of fissile alum, two parts ;
of stavesacre, one part \ triturate, and use.
BOOK THIRD. 269
Ok Madarosis, or Milphosis. — Tliis affection is a falliDg out
of the hairs of the eye-lids. Wherefore, after attending to the ge«
n^ral health, use the detergent ointments called calliblephara. Of
Cannel-coal, of Celtic safiron, of ladanum, equal parts. Pulverise,
and use. — ^Another : Of antimony, calcined and cleaned, dr. i. ; of
lead, burned and cleaned, dr. iv. ; of saffron, dr. iv. ; of Indian nard,
dr. iii. ; pulvmse, and use. — Another : Of burnt bones, of dates,
dr. iii. ; of Celtic nard, dr. ii. ; triturate, and use. This also cures
scabious eyes*
That or Nbopolitss for MiLPH08i»ANn Chronic Appsctions
OF THB £tb-lids. — Of Rutimony, of cadmia, of chalcitis, of foreign
misy, of each, equal parts ; beat together coarsely, mix with honey ;
when roasted, triturate, and use.
On Ptillosis. — Ptillosis is a callous thickening of the eye-lids,
of a red colour, and often accompanied with a falling out of the
hair. In addition to those already mentioned, the following is an
excellent application : — Rub with mice dung burnt, and triturated
in honey.
For a Falling Out of thb Hairs of the Eye- brows. — ^Anoint-
ing the fingers with oil, or geese fat, rub them upon lead, and
anoint with this. — Another, which also darkens the hairs : — Tritu-
rate burnt Pontic walnuts with the fat of goats or of bears. — Ano-
ther, which also applies to alopecia of the chin : — Of henbane, dr. ii. ;
of mice dung, dr. i. ; of maiden-hair, dr. i. ; of the ointment of iris,
four spoonfuls. Pound well together, mix the ointment, and,
haying first fomented, anoint. If you previously shave the part, it
will be the more efficacious.
For Trichiasis of thb £tb«lids. — Having first torn out the
hairs which irritate the eye, anoint the part immediately with the
blood of a frog by itself, or with the ashes of white chamseleon, or
the blood of bugs; or the fumitory, which grows among bar-
ley, mixing its juice with gum, or the ashes of pickled limpets with
cedar rosin (gumvernixPJ, or the ashes of the lotos; or liquid
alum, called phorimum ; or the blood of a tick taken from a dog.
It is very efficacious.
AooLUTiNATiVB Mbdicines. — ^Thc foUowiug substances aggluti-*
nate the hairs when bent inwards : bitumen, mastich, colophonian
rosin, glue, the glutinous part of snails.
On £ncanthis and Rhtas. — Encantjiis is an excrescence of
the natural fiesh at the great canthus, but rhyas is a wasting of it.
You may treat encanthis with the remedies mentioned for ectropion,
and similar caustic, or septic applications ; but the whole substance
must not be consumed, lest rhyas be produced, for it must only be
reduced to its natural size. Rhyas, when the whole fiesh is consumed^
either by an awkward surgical operation or medicines, is incurable.
But, if part of it only be lost, you may restore it by moderately as*
tringent and incarnating applications, such as that irom safiron,
homed poppy, and aloes ; and the safiron collyria, and henbane
hoiled in wine and applied, and a small quantity of alum with wine.
On Ulcers. — Of the ulcers in the eyes there is but one genus,
2/0 PAULUS iEOINBTA.
bat many particular species. For that in the cornea, when hollow,
narrow, and clean, is called bothrion. That whidi is broader than
the bothrion, but less deep, is called cseloma. Ar^emon is the
name given to that which arises on the circle of the iris, bat affects
the sarrounding parts, so that the part which is on the external
side of the iris is red, bat that on the internal white. Epicanma is
a foni and impure ulcer with eschars, which, when cleaned away,
often give vent to the humours of the eye. There are many other
varieties of ulcers, all of which we shall treat of in general terms.
If, therefore, the ulcer happen to be attended with inflammation,
the cure must be accomplished by such things as are calculated to
soothe and digest the inflammation, regard being had to the pecu-
liar nature of the ulcer. Such are the coUyria, called iibanium, *
cycnos, and palaria, aster, and the like ; and those from starch,
Bamian earth, and ceruse. But the most sedative coUyrium which
we are acquainted with is that of Nilamon ; and yet we must not
persevere long with it, because it is very narcotic. The best of all
applications is the coUyrium from decoctions not possessed of a
narcotic quality. But, if the ulcer be attended with a rheum, we
most mix some of the coUyria for it, such as that from the kydra,
the chiac, the yellow cycnos, and such as possess repellent properties
without being stimulant. When the ulcers are foul, we must use
honied-water moderately diluted, and the decoction of fenugreek,
by themselves, and along with the coUyria for that purpose ; when
they are acrid, we may use that of Severianus with the diachylon
from fenugreek ; when not acrid, those from m3rrrh and nard. When
the ulcers are cleaned, they may be cicatrised by means of the col-
lyrium called clean, in addition to which it wiU render the scar of
the same colour.
On PaociDBNTiii. — Procidentia is a projection of the coat called
Hva (irisPJ, formed by an ulceration or rupture of the comea«
When, therefore, it is smaU, so as to resemble the head of a fly, it
is caUed myooephalon. When it increases more, so as to resemble
a grape-stone, it is called staphyloma ; when it advances far for-
ward, so as to protrude between the eye-lids, it is caUed melon ;
and, if it has become callous, it is called clavus. If, therefore, the
projection is smaU, like the head of a fly, we must use repellent and
astringent applications, such as the chian, that called fiucum, the
mmrd, and the theodotian, and those from olive leaves, and from
horn. And we must bind upon them without pressure a piece of
sponge which has been soaked in ozyorate, or astring^t wine, or
the decoction of roses, or the compress called splenium may be used.
The best application for procidentia, and aU ulcers of the eye, is
the coUyrium called olympiac, or olynyms, with the juice of oUve,
or of knot-grass, or of poley. The same things are applicable to
clavus and staphyloma, before they whiten ; for, after they become
white and callous, they are incurable.
On Hypopyon. — Hypopyon occurs occasionally in the cornea,
being sometimes deeply-seated, and sometimes more superficially^
the matter assuming the shape of a nail, and hence the affection
BOOK THIRD. 271
got the name of onyz.^ The indication of cure is either to dispei
the pus by remedies possessing this property in a moderate degree,
such as honied- water, and the juice of fenugreek, and the collyria
formed from it, the libyanum, and those from frankincense ; or, to
make it burst, and cleanse the ulcer by means of the more potent
remedies, such as those called diasmyma, and the hygidian. For
cases of hypopyon without ulceration one may use the following
liquid eoUyrium : — Of copperas, and of saffiron, of each, dr. viii. ;
of myrrh, dr. iv. ; of honey, lb. i. The phlyctaena, being an eleva-
tion of the cornea, by a certain humour corroding its fibres, is to
be cured in the same manner as hypopyon.
Tbs Liquid CoLLraiA of Bassus for Hypopyon. — Of safiron,
of aloes, and of myrrh, of each, oz. i. ; of wine, oz. iii. ; of the finest
honey, oz. vi. The safiron is to be levigated with a small quantity of
the wine, then with the aloes and m3nTh ; and, when it thickens, add
the honey, and, having mixed together, lay up in a glass vessel, and
use twice a-day, or, if the case be urgent, three times. When the
eye is cdean, use incarnating and cicatrising applications.
On Cicatrices and Lbucom ata. — Superficial scars on the eye
are called by some cicatrices, and by others nephelia ; but the more
deeply-seated are called leucomata. The proper remedies for them
are those of a detergent and cleansing nature. Wherefore,
Uepfaelia may be cleans^ by the juice of anemone, and that of the
Saudi centaury, with honey ; but the more chronic are reduced by
Cedar gum, or by copper alone levigated with water for a colly*
liuin, and by the cleansing collyria, such as that from hartshonir
and those called rhinarian, hecatombe, and the like. Leucomata
may be cleared away by nitre carefully levigated with some old oil,
and properly smeared upon them, and by the shell of the cuttle-fish
fsepiaj burnt and pounded finely with honey. Among the colljnia,
the following one proves an excellent and mild detergent ; — Of
inamira, of ammoniac perfume, of Troglodytic myrrh, of crocodile's
dung^, equal parts ; make a collyrium, and use. Levigate the dung
of the land crocodile with water, and anoint, having formed it into
a coll3nrium. You may also succeed well by dissolving Cappadocian
Salts in water, and then dissolving the collyria for leucoma in it,
and injecting it«
Dtss for Cicatrigxs. — Of galls and acacia, of each, dr. iv. ; ci
copperas, dr. ii. ; use. The following is a collyrium : — Of the flowers
of the pomegranate, of copperas, of acacia, of gum, of each, dr. iv. ;
of antimony and galls, of each, dr. ii. ; triturate with water. When-
the flowers of the pomeg^ranate are not at hand, you may use the'
internal membrane between the seeds.
On Ftbrtgium. — Pterygium is a nervous (membranous ?) excre*
Boence of the tunica adnata, arising at the angle of the eye, and ad-
vancing to the corona. When it increases greatly, it covers the
pupil itself. Wherefore, large and chronic pterygia can only be
extirpated by a surgical operation. But the smaller and more recent
ones may be worn down by the 'abstergent applications, such ae
those used for trachoma and leucoma. Among Uie simple remedies
272 PAULUS JSGINSTA.
are burnt copper, and copperas with the gall of swine, which answer
well. The following is a more potent remedy : — Of copperas, p. i. ;
of gum, p. SB. ; triturate with wine, and anoint, or form into colly-
ria. Some mix the gall of a goat with honey, and anoint with it.
For Ftertoicjm, Hypopyon, and Dimness of Vision. — From
Oribasius. — Of the magnet stone, of scraped verdigris (xyston),
of reddle, of ammoniac perfume, of each, dr. iv. ; of saffi-on, dr«
ii. ; of Attic honey, half a spoonful. It also answers for leucoma.
For Carbunclb and Carcinoma. — Carcinoma is an affection of
the cornea, attended with pain, distension, redness of the tunics,
and pungent agony, extending to the temples, more particularly if
shaken. They loathe their food, and have the pain increased by
acrid things. The affection is incurable, but may be alleviated by a
milk diet, farinaceous, and otherwise wholesome food, devoid of all
acrimony ; and by the use of soothing coUyria, such as the spodiac,
severianum, and the like. We must previously attend that the ge-
neral system.be in a proper temperament. Carbuncle also is a
malignant ulcer of the sloughy kind, forming sometimes in the ball
of the eye, sometimes in the eye-lid, as in the other parts of the
body, In cases of carbuncle of the ball of the eye, we must first
evacuate with a clyster, and then purge moderately with boiled
milk, afterwards foment with a sponge, and apply a cataplasm of
the flour of tares, or of wheat boiled in honied- water, or sometimea
we may add pounded iris, and wash the eye with milk. If the ulcer
spread, we may apply a cataplasm of lentils with honey or boiled
quinces : if it continue spreading, we may use the boiled leaves of
tiie olive, the rind of the pomegranate boiled in wine and pounded
with honey. When the ulceration stops, and the eschar falls off by
the application of the medicine about to be described, and the ulcers
have become clean, we may apply a cataplasm of the roasted yolks
of eggs, triturated with sc^ron and honey, until the ulcer is healed.
The medicine is this :— Of spodium, dr. iv. ; of myrrh not much
toasted, dr. iii. and oboli iii. Triturate in Aminsean wine until it
become dry, mix old Cretan sweet wine, and, having triturated, lay
up the liquid in an earthen vessel, and anoint with it. For carbun-
cles of the eye-lids, having cut an acid pomegranate, boil it whole
in vinegar, and, when softened, pound and put into a linen cloth, and.
use. Change twice or thrice during the day, and once during the
night.
On Mydriasis. — ^When the pupil does not appear changed ia
colour, but much wider than natural, and when it sometimes wholly
impairs the vision, and sometimes nearly so, and when every object,
appears smaller, the affection is called mydriasis. The cause of it
is some redundant humour. We must cure it by bleeding from
the arm, or purging ; but, if not, by dividing the veins in the angles ■
of the eye, and then applying a cupping -instrument to the back-
part of the head, and bathing the face and eyes with sea- water, or,
if it be not at hand with brine or oxycrate. We must use the reme-
dies which are applicable to phlyctsense or blisters.
On Phthisis and Atrophy. — Phthisis is an affection of the pupil.
BOOK THIRD. 2/9
wbiofa is contrtcted, and appears duller and more rugose than usual,
bat objects seem larger than natural. The cause of it is condensa-
tion, mostly occasioned by dryness. Phthisis differs ftrom atrophy
in tliis, that phthisis renders the pupil contracted* whereas in
atrophy the whole eye is smaller and more depressed. We maj
cure them by exercise, and rubbing carefully the head, the face, and
the eyes ; by bathing the face with water, and anointing the head
with some warm ointment ; and smearing the eyes with an attena-
ant and acrid composition, such as the following : — Of ammoniac,
dr. i. ; of crocomagma, dr. iv. ; of saffron, dr. ii. ; of verdigris, dr.
i. Triturate in water, form, and use.
For Nyctalopia. — In the disease called nyctalopia, the patient
sees during the day, but at sun* set his vision becomes dimmer, and
when night comes on he does not see at all. We must effect the
cure by bleeding from the arm and the angle of the eye, then purg-
ing, or evacuating by a clyster, and afterwards ordering masticato-
rie9 or sternutatories. Before food, we give hyssop to drink, or
me ; but, if the disease do not yield, we must again administer the
purgative medicine formed from scammony and castor, anoint with
^arified honey, and make the patient shut his eye-lids, so as to re-
tain the liquid application. Or, of burnt alum, p. ii. ; of fossile salt,
p. i. ; triturate with honey, and anoint. Another : — Having roasted
ihe liver of a goat, collect the ichor during the roasting, and anoint.
l)ut give the liver itself to eat ; or, boil and direct to receive the
vapours witli open eyes.
For Glaucoma and Suffusion. — From Ruffus. — ^The ancients
^HMiBidered Glaucoma and Suffusion as the same disease ; but by their
successors Glancoma has been accounted an affection of the crys-
'Calline humour, which is changed by a watery substance to a cseru-
^ean colour ; but Suffusion is reckoned a defluzion of humours con-
^»ieted between the cornea and the crystalline lens. Glaucoma is is
^very case incurable. Suffusion may indeed be cured, but not always.
'^Ve may try to cure suffusion, before the disease is completely
formed, by taking blood from the arm, by purging, and acrid clys-
'^rers, sodi as those made from the decoction of centaury, or of the
^Ditter ci^uimber, and by keeping the belly for some time in a loose
itate. Cupping- instruments with scarifications may be applied to
hind-head ; the patient must drink water during the whole re-
gimen, take attenuant food, and, in process of time, masticatoriea
^:»ay be used for a few days with advantage. When the vision is
^:iepraved, as, for example, gnats appearing before the eyes, which
^:iase proceeds from a cacochymy, or from bilious vapours ascend-
^^g to the head, we may give for a time the bitter medicine from
^^-loes, or purge with it. To the eyes we must make applications at
'Gjrst simple, such as honey and oil, with the juice of fennel, and af-
"^^rwards compound, such as this : — Of sagapene, dr. ii ; of cyre-
^^aic juice, of white hellebore, of each, dr. vi. ; triturate with eight
^eminaB of honey. We, says Oribasius, use the following me-
Aicine : — Of the juice of wild carrots, of germander, of cresses, of
^^» equal parts; triturate. The following coUyria are beneficial,
T
274 PAULUa iEOINBTA.
namely, that from the juice of the fennel, that called protetts, the
thalasseros, and that from opobalsam. The collyria prepared from
them are useful, and the decoction of fennel in the commencement
answers well as a fomentation, and that from juices, opobalsam,
honey, old oil, and the like.
On Amaurosis and Dimnbss of Sight. — Amaurosis is, for the
most part, a complete impediment of the sight without any appa-
rent affection about the eye ; and dimness of sight is an imperfec-
tion of vision arising without any sensible cause. The same mode
of cure as that described for suffusion applies generally in this case ;
but, in particular, blood may be abstracted from the comers of the
eye, leeches applied to the temples, and friction used to the extre-
mities. In process of time, we must use sternutatories, emetics
with an empty stomach, and the application of ointments, at first
with equal parts of honey and oil, and afterwards with the under-
mentioned composition : — Of saffron, two oboli ; of the gall of the
hyaena, dr. i. ; of common pepper, eighty-five grains ; of fennel
juice, dr. xvi. ; of ammoniac perfume, dr. i. Triturate the dry sab-
stances with the juice, add four spoonfuls of honey, prepare, and
lay up in a copper vessel for use, Before using, foment the eyes
by immersing them in hot sea water.
On Strabismus, or Squinting. — Congenital squinting is cured
by the application of a mask, so as that the children are compelled
to look straight forwards ; for strabismus is a spasmodic afifection of
the muscles which move the ball of the eye. And the lamp should
be placed fairly opposite, and not so as to shine obliquely. When
the eye is turned to the nose, purple flocks of wool should be £eis-
tened to the outer angle of the eye, so that, by looking steadily at
them, the persons affected may correct the state of the eyes.
On Ecpiesmus. — The eyes are sometimes forced out, so as to re-
main prominent. When this happens from strangulation, we must
let blood from the arm ; but, if otherwise, we must purge with
black hellebore or scammony. When the eyes become prominent
from the pain of labour, the complaint is often removed by the
cleansing after parturition. Hence we ought to co-operate with
them ; and, in men, after phlebotomy, if it do not abate, we may
affix a cupping-instrument to the back-part of the head, and ap]dy
wool smeared with honey, or flocks of it with water, and bind, a
compress gently above it. Cold salt water poured upon the face is
likewise suitable to them, and also the juice of endive and knot*
grass, with the juice of poppy when rubbed in, and whatever else
can repress and contract.
On Synchysis, or Confusion. — Confusion of the vision occa-
sioned by a blow may be cured by bleeding from the arm, and fill-
ing the whole eye with the blood of a newly slaughtered animal, of
a turtle in particular, but, if not, of a pigeon, and then applying
soft wool which has been immersed in an egg beaten up with wiaa
and rose-oil, and binding it on the place. The same thing is
to be done next day ; and, on the third, it is to be fomented^
washed with milk, and suitable cataplasms applied ; after whidi, i^
BOOK THIRD. 27^
/
is to be anointed with the remedies for old affections, such as the
cbiac.
/ For Myopia. — ^Those persons are called myopes who, from their
birth, see near objects, but not those at a distance. Such a state is
wholly incurable, being occasioned by a weakuess of the optic spirit.
Old men are affected in the opposite manner to these, for they do
not perceive near objects, but see those at a distance.
XXIII. — On Diseases of the Ear ; and, first, concerrdng Pain
of it,
Earacb occasioned by cold may be judged of from the season
of the year, the preceding regimen, or from the patient's own ac-
count, if it proceed from any external exciting cause. If the pain
be deep-seated without heaviness, distension, or heac, such cases
are to be cured by calefacient remedies, as hot oil of rue, or of
nard, or hot oil of bays, or that of marjoram, that called fol'tatum,
or that called spicaivm, or the common one w itii ciiphorbium, or
pepper, or castor, or the ointment called commayeniim, or opobalsam
poured into the auditory foramen, and oil in which garlic or onion has
been boiled is of service when injected. Fain from a hot intempera-
ment is judged of by a certain sensation of beat without heaviness
or tension. You may cure it by the opposite remedies ; by injecting
the white of an egg triturated, as in affections of the eye ; and
woman's milk, along with some of the anodyne collyria, or the juice
of perdicias, with a small quantity of rose-oil, and rose-oil itself, or
rose-oil and vinegar, or the juice of the night-shade, or of coriander,
or of king's-spear, or oil in which earth-worms, or millepedes have
been boiled ; or almond oil, either by itself, or having three living
buccinae boiled in it, is of great natural efficacy. Pain from viscid
and thick humours you may judge of from the heaviue&s of head,
and from the previous regimen. When it is without heaviness, this
state alone of hearing indicates a flatulent spirit that cannot get
vent. In both these cases, we must use remedies of a deobstruent
and incisive nature, such as the aphronitrum with vinegar and
honey, and sheep's gall with common oil, or the oil of almonds,
and the warm juice of leeks and onions with honey ; or, triturate
common marjoram with honey and a woman's milk, and inject it.
For stronger coldness, pour in goat's gall with the juice of leeks ;
and, when the pain is great and of long duration, and when difficulty
of hearing is present, we must use these remedies, namely, the
juice of dracunculus, of wake-robin, and of bryony, and the like.
When the pain is occasioned by a flatulent spirit, it may be greatly
remedied by applying a cupping-instrument previously heated in
hot water, and affixed near the ear. But, if there be heaviness,
distension, and heat, with a pulsatory pain or fever, you may be sure
that the ear is inflamed ; and you must, in the first place, have re-
course to phlebotomy, then foment frequently with hot sweet-oil
by means of the ear specillum wrapped in wool. We must also in-
T 2
BOOK THIRD. 'XJj
first with ozycrate in oxymel, or in mulse, or in a decoction of
some repellent article, such as dried lentil or roses.
Fob Bloody Ears. — Wash with the decoction of bog-rush, and
inject the juice of knot-grass, with a little vinegar, or lycium, or
lees of oil, or acacia, or the juice of leeks.
For Fungous Flesh. — Wash nitre in hot water, and use with
equal parts of flakes of copper and sandarach. Clean the eschars
which are formed by it with honey.
For Vermis in the Ear. — Wash with a decoction of worm-
wood, centaury, or leeks ; inject the juice of the green leaves, or of
the fruit of cappers, or cedar gum, or old human urine, or white
hellebore with honey, or the juice of calamint, or scammony with
vinegar, or the juice of worm-wood. Oil poured into the opening
of the ear, so as to make them ascend to the top, answers well. But
the best application is vinegar and oil. It also applies to animal-
cules which fall into the ear.
For Calculi and the like which have fallen into the Ear.
— ^Wrap some wool about an ear specillum, and dip it into turpen-
tine-rosin, gum, or some glutinous substance, and thus draw it out ;
but if it does not yield, pour frequently warm oil into the passage ;
and if it do not fall out or is left behind, use the other means to be
described in the surgical part of this work.
On Noises. — If noises occur in fevers at their crisis, they ought
not to be interfered with, for they will commonly cease of them-
selves ; but, if they remain after the disease, having fomented with
the decoction of worm-wood, inject vinegar and rose-oil, or the
juice of radish with rose-oil, or that of black hellebore with vinegar.
For chronic noises occasioned by thick and viscid humours (which
you may know from their coming on not suddenly, but gradually),
syringe with vinegar, nitre, and honey. Another ; — Of white helle-
bore, dr. ii. ; of castor, dr. ii. ; of saffron, dr. iii. ; of nitre, dr. xvi.
Make trochisks, which triturate in vinegar, and use.
For Chronic Noises and Hissing Sounds. — Triturate euphor-
bium with oil of privet, heat, and use. When, from increased sensi-
bility, they experience the sensation of vapours or spirits carried
upwards, triturate castor and the seed of hemlock with vinegar, and
inject.
On Difficulty of Hearing, and Deafness. — Those cases which
are congenital, or which, although not congenital, are inveterate,
and attended with complete deafness, •are incurable ; and those
which, although not complete, are inveterate, prove also incurable,
or difhcult to cure. Those which are formed by a bilious humour
ascending upwards, you may easily cure by evacuating with chola-
gogue medicines; and sometimes the complaint goes off spontaneous-
ly, when bile is discharged downwards. Deafness, or difficulty of
hearing, occasioned by crude and thick humours, you may cure bv
opening a vein, by purging freely with hiera, and by using masti-
catories, errhines, and natural or salt baths. It is also proper to
inject into the ear those things which are recommended above for
noises. But the following are particularly applicable : — Inject the
278 PAULUS iSOINETA.
urine of a goat and the gall of a goat together, or the gall singly ;
or the juice of rne with honey ; or castor with the oil of dill ; or the
medicine cBsypum with nard ointment ; or the gall of a goat with
galhanum ; or this : — Of castor, dr. ii. ; of nitre and white helle-
bore, of each, dr. i.
For Contusions op the Ears. — Hippocrates recommends to
apply nothing to them ; but, since we are often compelled by those
who have sustained the injuries to do something, we may use the
following : — Of myrrh, of aloes, of frankincense, of acacia, equal
))arts ; anoint with vinegar, or the white of an egg. Or, pound in
a mortar the inner part of warm bread with honey, and apply as a
cataplasm. Or this : — Of bitumen, of frankincense, of aloes, of the
flesh of snails, of African bulbi, equal parts, triturate with vinegar,
and apply. When there is inflammation, triturate with oily grain
(sesamej, or with chondrus boiled in vinegar, and apply as a cata-
plasm ; but let the cataplasm be light, and not bandaged at all, or
but slightly ; and let wool dipped in oil be introduced into the
|)as8age.
On Parotis. — Parotis is an aflection of the glands about the ears,
being sometimes occasioned by humours from the head which are im-
pacted in it, and sometimes by those collected from the rest of the
body during the crisis of a fever. If it be deep-seated, and do not
occasion a swelling, we may assist nature by applying attractive re-
medies, either by putting on a cupping-instrument, or using fre-
quent fomentations. For, if the matter be determined inwardly,
there is no ordinary danger ; but, if it inflame and swell out to a
tumour, we must, on the contrary, use soothing and digestive cata-
plasms, such as that from barley flour, that from wheat, or from
the flour of linseed with honied water, or boiled with the decoction
of fenugreek, or of marshmallows, or of. camomile, and that from
dock and axunge without salt. But, if it appear that there is a
fulness of blood, we must first evacuate by phlebotomy, if the
strength permit ; but, if the swelling be not dissipated, we must
use suppurative medicines, such as wheat flour, with the de-
coction of dried figs and oil, and the application made from pollen
and that from yeast. When the aposteme is converted into pus,
we may evacuate it either by opening it, or produce its rupture
by means of an acrid medicine, such as that called smilium, or
that from garlick. The milder kinds of parotis are discussed by a fo-
mentation of salt water, or the composition from Aperanus. This
medicine is calculated to discuss the converted pus, and to prove
very anodyne. For inveterate cases of parotis, we may apply the
ashes of burnt buccinse, or purpuras, with honey or axunge, or figs
boiled in sea- water, or horehound with salts. Hard ones are softened
by the composition of Mnasseus, and that of Ariobarzan ; but one of
the best applications is that formed from the juice of linseed. But,
before using these, we arc to aj)ply cataplasms of ammoniac, mixing
with them liquid pitch, bull's fat, bdellium, storax, or harts' mar-
row.
BOOK TUIBD. 279
XXIV. — On the Affections of the Nose, and of the Sense of
Smell,
When the faculty of smell is impaired, but the speech remaius
uninjured, it is to be suspected that the anterior cavities of the
brain are affected, being impaired either by a simple intempera*
ment, or a collection of noxious humours. But, if the voice be at
the same time impaired, and has become thick, it is to be conjec-
tured that the affection proceeds from certain noxious humours ob-
structing the ethmoid bones. Having ascertained the intempera-
ment of the brain from the symptoms often mentioned, use the
opposite remedies. Evacuate the humours by masticatories, and
more particularly by powerful errhines ; but apply attenuant aro-
matics as for catarrh. But, if you suspect a plethora of the whole
body, in the first place evacuate it by venesection, or by purging
with hiera. Do so likewise for polypus and ozaena. Then use the
topical applications. Theriac also is often drunk with great adyan^
tage. Polypus is a preternatural tumor formed in the nose, resem-
bling the flesh of the polypus. The sarcoma is a substance of the
same kind ; but ozsena is a putrid ulcer formed by a defluxion of
acrid humours.
For Polypus and Sarcoma. — Of the flakes of copper, dr. viii ;
of copperas, dr. vi. ; of sandarach, dr. iv. ; of black hellebore, dr.
ii. Blow in, and use confidently, as being an excellent remedy ;
for in thirteen days it will prove of manifest service. Copperas
alone with vinegar is of •use. Another : — Of the rind of pomegra-
Bate, dr. xii. ; of copperas, dr. x. ; of chalcitis, dr. viii. ; of bull's
gall, of amomum, of myrrh, of calamint, of horehound, of each, dr.
iv. ; of saffix>n, dr. ii ; of white hellebore, dr. iv. Use in a powder.
Another: — ^Touch with levigated diphryges {husk of brass?), and
distend the nostrils with the pledget from lamp wicks.
For Oz^na. — Of misy, chalcitis, and myrrh, of each, dr. vii. ;
of copperas, dr. vi. ; of fissile alum, of galls, and of the flakes of cop-
per, of each, dr. iv. ; of round alum, dr. ii. ; of frankincense, dr. i. ;
of vinegar, one sextarius. Boil the whole in a vessel of copper, and,
when of the consistence of honey, use upon tents. Another : — Of
verdigris and flakes of copper, equal parts. Use in a dry state.
For Fbtid Smells op thb Nose. — Of myrrh, of acacia, and of
amomum, of each, dr. i. ; mix with boiled honey, and direct that it
be glued to the extremity of the septum narium. Another : — Of
amomum, of myrrh, of dried roses, equal parts; mix with nard
ointment, and anoint with it. The malagma of Hedychroum with
wine produces the same effects.
For Ulcers in the Nose. — Of white lead, lb. i. ; of litharge,
oz. iii. ; or, of the dross of lead, oz. iii. ; of burnt lead, (see that all
be washed) ; mix with wine and m3rrtle oil.
For those Ulcers called Sweet. — Of litharge, dr. iv. ; of
fresh rue, dr. iv. ; of fissile alum, dr. ii. ; mix with myrtle oil and
vinegar.
380 PAULU8 MQINKTA.
Stsrnutatoriss. — White hellebore, castor, pepper, fuller's herb,
either alone or together. They must not be blown in» .bat applied
with a feather or the end of a finger to the innermost parts of the
nose. If the sneezing continue too long from the use of the medi-
cine, it may be appeased by injecting into the nostrils some nard, or
rose-oil, or sweet oil. Sweet-scented things, likewise, appease
sneezing, as anise, and the pounded chaff of basil. In all these
cases, the head must be dried by detergent ointments (amegmata}
of nitre and pumice stone, or we may use that which is called
iEsculapium, and the soap of Constantine, the Cappadocian salts;
and the like.
Fob Hemorrhagb from thb Nosb. — Of bleeding from the nose
in fevers we have treated in the Second Book ; but we shall now
treat of it when it arises from any other cause, and is difficult to re-
strain. Triturate chalcitis, and apply upon the tent formed ^m lamp
wicks, or the one called Priapiscus, soaked in water, and press it
into the nostrils ; or, bum an egg-shell, and add to it of galls OQe->
half; or, touch it with Indian lycium ; or, blow in the ashes of
burnt ass' dung ; or, press out the juices from it, and inject into the
nose ; or, let him smell to the vapour of lapis molaris, heated and
plunged into vinegar ; or, use the following obstruent preparation :
Of the manna of the frankincense tree, p. i. : of aloes» p. sa. ; mix
with the white of an e^, and use, by means of a tent made of
lamp wicks, having added to it externally the down of a hare ; or,
apply to the nostril the preparation called Lysimachium ; or, apply
for a length of time a large dry cupping- instrument to the hypochoo-
drium of the side from which the blood flows ; or, stuff the ear
firmly ; or apply sponges out of cold water to the forehead ; or w^
ply a cupping-instrument with scarifications so as to detract blood i
and, sometimes, it will be proper to let blood from a vein, if this be
not contra- indicated ; and apply ligatures to the extremities, morft
especially the arms and thighs, as if for venesection. Direct to
make motion with them exerting the hands by rubbing, and the
feet by walking ; for, when the veins there are filled with blood,
the parts about the nose will have a smaller supply of it. But •
sponge soaked in cold oxycrate and bound externally to the bleed**
ing nostril will often accomplish the purpose. It is best^ however^
to stuff the nose first with a long tent in the form of a wedge.
XXV. — On Affections of the Face.
How TO PRBSBRVB THB Face frbb FROM Wrinklb^. — Of frank-
incense*, dr. iv. ; of fucus, dr. iii. ; of washed litharge, dr. viii. Dis»
solve them all in a decoction of bruised ichthyocoUa, make tro-
chisks, and use. Another : — Of ivory shavings, dr. viii. ; of male
frankincense, of ichthyocoUa, the same quantity. Use as aforesaid.
Fob Darknbss of the Facb. — Of iris, of ptisan, foi bruised
beans, of each, a sextarius and a-half ; of sal ammoniac, of bamt
hartshorn^ of ammoniac perfume, of each, oz.4i. Dissolve in water*
BOOK TUlftD* 28t
ftod make trocbisks, and, having again triturated with water, anoint
before bathing. Another : — Of ptisan, of tares, of frankincense, of
braised beans, of Ill3rrian iris, of aphronitmoi, of costus, of each,
the foorth-part of a chcenix ; bitter almonds, xx. in number ; form
with the white of an egg and the milk of an ass, and use as afore-
said. The trochisk Peponatus also answers well.
For Frxcklbs and Lentigo. — Of burnt Cimolian earth, half a
hemina ; of burnt aphronitrum, dr. viii. ; of the flour of tares, dr.
iv. ; of the refuse of bull's gall, dr. viii. Triturate and use. Ano-
ther ^— Of the lees of wine, dr, x. ; of the flour of tares, dr. x. ; of
bruised beans, dr. x. ; of white hellebore, dr. v. ; of aphronitrum,
dr. X. ; of alcjonium, dr. x. Triturate, and rub with it.
Fom Bruised Spots, or Htpopia. — First foment with the de-
coction of fenugreek, and afterwards with that of melilot, mix the
ooUyrinm of Nilus from roses with water, and anoint ; then use the
myrrh collyrium. If these do not produce the eflect, anoint with
the collyrium of burnt sandyx ; or, apply hyssop with water ; or,
bind hyssop into a piece of rag, dip it in warm water, and foment ;
or, foment with strong salt water, and rub down the skin of radish
wi^ hone^, and apply. This answers also for chronic cases. For
chronic «potB and lividity, take of Cretan hartwort two parts ; of
Samian euth, one part ; apply with honey, taking care that it do not
produce an tdcer. Another abstergent application : — Of hyssop, of
thapsia, and of cassia, of each, dr. ii. ; of wax, dr. ii. ; of turpen-
tine, dr. i. Apply, taking care that it do not occasion an ulcer,
and Oft that account it is to be removed frequently.
For Vari or Warts. — ^They are small hard tumors about the face.
Anoint, byrubbing with oxymel ; or, triturate litharge with turpentine
and some white oil, and anoint by rubbing ; or, rub in fissile alum
with tttrpentine ; or, triturate bitter almonds in vinegar, and rub.
For callous vari :— Of Gallic soap, dr. iv. ; of frankincense and
amiAoniae, of eac^, dr. i. Dissolve in water, and anoint ; after an
lioiir« wttsh away.
For Vari, Hairs, and Roughness of the Face. — Of wax, dr.
^. ; of turpentine, dr. i. ; of misseltoe, dr. ii. ; melt, adding a small
quantity of oil, and scrub the face with it, for it takes out the hairs
by the roots. Another : — Apply powdered poppy, or penny-royal,
With salt and vinegar.
The Cerate of Thais for rendering the Face Ruddy. — Of
Raffipon, of madder-root, of fucus, of frankincense, of mjrrrh, of each,
^r. ii. ; mix with calf's fat, and mastich oil, and then anoint, and,
Hfter a little interval, wash away with a sponge out of hot water.
Tliese applications for the face will also answer for other parts of
the body.
TiJLYI.^On AfecHoHS of the Mouth; andjftrst^ of the Teeth.
Tbx teeth Rre pained without inflammation of the gums, some-
tiaicB from pain attacking the body of the teeth, and sometimet
283- PAULUS vKOINBTA.
from the nerve which enters them heing affected. Wherefore they
require the strongest remedies ; the greater part of which are pre-
pared from the most acrid vinegar. When the gums are pained
from inflammation, the hest application is oil of lentisk retained in
the mouth in a tepid state. But see that it is new ; for the older
it is so much the worse is it for this purpose. This general rule
ought to he ohserved, to evacuate first whatever humour prevails in
the general system.
For Inflammation op thb Teeth. — Wash with vinegar in
which have been boiled galls, or the root of winter-cherry, or the
seed or leaves of henbane, or penny-royal, or the juice of night?
shade, or the root of cappers, or the leaves of myrtle, or poley, or
the root of the wild cucumber, or the leaves of rue with oxymel, or
hartshorn, or the vinegar of squills, or pellitory with hyssop. To
the eaten part of the tooth apply storax with opium, or galbanum»
or sulphur vivum with lycium ; or, let the patient inhale the steam
from the seed of henbane through a small funnel. And the antidote
of Philo, if applied round the tooth, removes the pain. When there
is a defluxion on the teeth, rinse with a decoction of myrtle, lentisl^:,
and galls, or of Syrian sumach, or of the flowers of the wild pome-
granate, or of its rind. Sprinkle also of salts two parts ; of burnt
alum extinguished in vinegar and pulverised, one part ; then wash
with wine. For bloody gums, sprinkle fine alum, or rinse with
aloes in wine, or with the root of bramble boiled in wine, or Syriac
sumach. When the gums both bleed, and there is a defluxion from
them, bum pickled tunny in a pot until it be reduced to ashes, with
which touch the parts. Loose teeth are fastened by being sprinkled
with aloes, or Syriac sumach, or fissile alum, or galls, or the root
of bramble, either by themselves or boiled in wine. Another : —
Pulverise the bark of green nuts, and to the expressed juice add
Minnaean myrrh, and fissile alum, and mix together, and use, by
pouring it into the mouth, and put upon the gums of the pained
tooth, which it will cure. Another :r— Triturate together garlic,
pepper, and stavesacre ; put into a linen cloth ; make small balls of
it, and change frequently ; by which means you will purge the hu-
mour in the head, and efifect a cure of the teeth.
For Loose Teeth^ Running Gums, ANn for syert Sprbadinq
Ulcer in the Mouth. — Of burnt chalcitis, dr. xii. ; of calamine^
dr. viii. ; use in powder with vinegar.
How TO remove the Teeth without Pain. — ^Apply flour with
the juice of spurge, and above it an ivy leaf, and leave it for an hour.
They will spontaneously fall out.
A Dentifrice, also for Parulis, or Gum Boil. — Of that kind
of alum called plinthitis, oz. iv. ; of sal ammoniac, oz. iv. ; of myrrh,
of costus, of pellitory, of each, dr. iv. ; of pepper, eighty grains.
For Parulis. — Of sulphur vivum, of pepper, of fissile alum,
equal parts. Parulis is an inflammation in a part of the gums*
which, not being resolved, suppurates. Having suppurated, and
being divided with a scalpel, it is to be kept separate with a tent.
Epulis is a fleshy excresence from inflammation on the innermost
BOOK THIRD.
dens molaris, being attended sometimes with fever and pain. It
mast be repressed ; and, therefore, we must use the species of ver-
digris called xyston, either by itself, or with an eqaal part of galls,
or burnt sori, or burnt alum, or galls alone, or the flakes of copper
triturated with vinegar for a sufficient number of days and dried.
A Dkntifricb. — ^The burnt roots of birth wort, burnt hartshorn,
with some mastich. Another: — White salts mixed with honey,
and wrapped in the leaves of the fig-tree, and burnt until reduced
to ashes. Another : — Buccinse filled with salt and burnt ; land snails
burnt with honey ; unwashed wool burnt with a little salts. With
each of these, for the sake of fragrance, let there be mixed the
schenanth, or spikenard, Indian leaf (malabathrum), or C3rperus, or
iris.
An Application which will Whiten the Teeth, Repress
Swelling of the Gums, and Produce Fragrant Breath. — Of
Pumice-stone, of roasted salts, of iris, of each, dr. iv. ; of cyperus/
dr. V. ; of spikenard, dr. i. ; of pepper, dr. vi. ; pulverise, and use.
For Dulnbss of Feeling. — Stupor in the teeth is relieved by
chewing purslain, or by rubbing oil of unripe olives, or by lees of
oil boiled in a copper vessel to the consistence of honey, and rubbed
in after being long kept.
For Worn Teeth. — For worn teeth, apply, of bay- berries, of fi8«
sile alum, of the climbing birth wort, equal parts.
For Corroded Gums. — Of the flowers of roses, dr. viii. ; of galls,
dr. iv. ; of myrrh, dr. ii. Erosions and running from the gums are
enred by washing with ass's milk, the decoction of olive leaves, or
vinegar of squills ; or by the following dry applications : the rust of
iron, and flowers of the pomegranate. For swelling and fungous flesh
of the gams, the juice of purslain retained in the mouth, the brine of
pickled olives, warm oil of unripe olives, or lentisk oil, or oil of
apples, or lees of oil, are applicable ; and the following powders :
the rust of iron or copper, the roots of birthwort, the seed of plan-
tain, diphryges, calcined copperas, pomegranate flowers.
For Fissures of the Lips. — Rub with boiled lees of oil. Or this:—
Of geese fat, with honey and turpentine, equal parts ; of the flowers
of roses, of the sordes of unwashed wool, of rose-oil, a small quantity.
On the Disease called Ranula. — Ranula is an inflammatory
^welling which forms below the tongue, particularly in children ;
Wherefore rub the part with misy and scraped verdigris CanfstonJ of
^ach, eqnal parts, in powder ; and to the chin apply the plaisters called
^nthentm, sphcmum, and the parygrum from eggs. But, in adults,
divide the veins below the tongue in the first place. Another : —
(It answers likewise with aphthae) of scraped verdigris, of galls, of
^balcitis, equal parts. With must it will form a gargle. Another: —
having previously rubbed with the flour of tares and honey, anoint
>rith galls triturated in honey, or with the flowers of roses in like
ikianner, or rinse the mouth with a decoction of olive leaves.
For Inflammation op the Tonsils. — If the tonsils and uvula
\)e inflamed in a fever, the most proper gargles are the decoctions
of bnan, or of roses, or of dates, or of Sebesten plums, or of dried
284 PAULU8 iEGlXETA.
lentil. When the inflammation is at its acm^, or is on the decline,
we may mix with them some honey, which we must not do at the
commencement, nor during its increase, lest, hy its acrid nature, it
attract a defluxion. If it suppurate and hurst, the patient must
gargle with honied- water, or with the decoction of lentil, or of
roses, persevering until it is completely resolved ; or we may give
him to gargle some of the mixtures for rinsing the mouth. If pes-
tilential ulcers in the tonsils take place, we may use the afore-men-
tioned remedies, and particularly apply the gargle from mulberries
with hot water, or hydromel, having thB flowers of roses sprinkled
npon it, or costus, or sumach, either in powder or in a decoction ;
or a decoction of the dried leaves of horned poppy. It is bitter ;
and it answers best if you dissolve the juice, as we use it for colly-
ria, in honied water. It may also be used with advantage by blow-
ing in the dried herb, or applying it upon the finger. Care must
be taken not to touch it with the hand, or, at least, it should be
▼ery gently. The trochisk of Andron is also of service. After the
irritation from these things is removed, they should use a gargle of
liquorice, or that from Scybelitic wine, and of saflron, and of Chian
mastich, and of mjrrrh, and afterwards of starch and tragacanth.
When the ulcer has stopped spreading, they may use a gargle of
milk and Samian earth. Another for antiades : — ^Pound sweet po-
megranate along with its peel, and mix six parts of its expressed
juice with one of honey, boil to the consistence of honey, and
anoint. Another : — Of immature galls, oz. ii. ; of fissile alum, oz.
i. ; of burnt sal ammoniac, oz. i. ; touch with it in powder. An«
ther : — Of galls, dr. viii. ; of misy, dr. ii. ; of roasted salts, dr. v. ;
use in powder. Antias is a scirrhous swelling of the tonsils.
On the Uvula. — ^When the uvula is inflamed, we must use
the gargles recommended for inflammation of the tonsils, and
those of a moderately astringent nature, such as the juice of pome-
granate, applied by means of a small spoon, or the surgical in-
strument invented for the purpose ; and these things may be ap-
plied either by themselves, or with moderately boiled honey, or the
liquorice root may be mixed with the pomegranate juice. The
juice of the liquorice root enveloped in honey also answers well. The
swelling may be repressed by the following substances : blood stone,
the Phrygian stone burnt, agerat, the composition from Phrygian
stone used for complaints of the pudenda; also Samian eiuth,
Eritrian, Sinopic reddle, the Lemnian earth, the oil of unripe
olives by itself, or with some of these ; and the fruit of the Egyp-
tian thorn, and fissile alum. The seed and leaves of roses act more
mildly, but still more so gum tragacanth, sarcocoUa, and starch,
which we must use, if pained when repressed by astringents.
When the swelling is of equal thickness throughout, in which case
we call the disease Columella, we must use the gargles prepared
from myrrh, safl^on, and cyperus, and avoid all pressure, and rather
anoint with a feather. The following composition answers well :
Of Syrian sumach, dr. viii. ; of saflron, dr. iv. ; of costus, dr. viii ;
of rose-seed, dr. iv. It may also be applied to the gums. Bat a
HOOK THIRD. 285
thread of a sea- purple colour which has heen bound round the neok
of a viper and strangled her, has wonderful effects as an amulet in
relieving affections of the tonsils and neck, as Galen testifies.
For Hbmorrhaoss prom thb Mouth. — Apply the pounded
leaves of leeks ; or, dip a new piece of sponge in raw pitch, bum«
pulverise, and use. It is also beneficial to rinse the mouth with
a cold decoction of green or dried roses, that of vine tendrils, or oi
the leaves of lentisk, or of bramble, or of quinces, or of roses, or of
grape- stones, or of lentils.
XXVII. — On Anginaj or Quinsey^ and the Complaints allied
to it J in which the subject 0/ those who have been strangled,
or otherwise suffocated, is treated of.
When the parts within the pharynx are inflamed, the disease ia
called S3naanche ; when those without it, Parasynanche. In like
manner* when the parts within the larynx are inflamed, the disease
is called Cynanche ; and, when those without it, Paracynanche. All
these complaints are accompanied with orthopnoea and pain, with
difficulty of breathing, and in some cases with fever. There is
redness of the face and neck, and swelling in some cases, when the
mouth is kept constantly open, and they cannot swallow drink«
Cases of cjrnanche are sometimes attended with a sense of suffoca-
tion. This disease attacks children but rarely, and then only from
injuries of the spinal vertebrae occasioned by a fall, — which case«
being incurable, is not to be meddled with. In the others, we must
immediately bleed from the arm, and take away not a great quantity
at once, but in divided quantities; for, from a rapid evacuation
there is danger gf suffocation, from the matters rushing to the af-
fected part, if the patient should faint. Should they not be im-
mediately relieved by it, we must open the veins below the tongue ;
or make incisions into the tongue itself, if it be swelled and pro«
trude out of the mouth. The belly is to be evacuated by acrid
clysters, hot water is to be poured upon the feet, and the ex-
tremities firmly bound with ligatures. The neck is to be wrapped
in unwashed wool, or in wool smeared with oil, and a cataplasm of
i-aw barley meal applied. At the commencement we may use the
gargles described for inflammation of the tonsils, or the simple
ttnedicine from mulberry, with the decoction of sumach ; but the
best remedy is that from wild mulberry, and after that the
compound application from mulberry, or the parts are to be
anointed with the composition from walnuts. When the disease
is at its height, we may add a little nitre or sulphur vivum, unless
the acrimony prohibit their use. And dog's dung, dried and
powdered^ and rubbed in with honey, is a most excellent applica-
tion, more especially the white kind ; also, the dung of wild swal-
lows, in like manner. When the complaint is of long standing, we
may use the liniment from besasa, or wild rue, sometimes increasing
and sometimes diminishing its strength by the mixture of other
medicines. Cupping instruments or leeches are to be applied to the
386 PAULUS ifiGINETA.
chin and neck, and the patients must use the stronger gargles from
iris, hyssop, gith, southern wood, liquorice, dried figs boiled in
honied water, or in the juice of rue with milk, or mustard with
oxymel. If irritation arise from the use of them, we must give
warm oil of the finest kind, or rose-oil by itself, or with the juice
of ptisan or of fenugreek, to gargle with. The food should be
honied water until the third day, after which the juice of ptisan,
with some of the sweet drinks, and then the yolks of eggs in a
liquid state. They may use spoon-meats made from chondrus, when
deglutition is unobstructed, and food suitable to their strength.
When the disease is on the decline, we may get them to take exer-
cise and the bath. The parts are to be enveloped in a cerate of the
oil of rue ; and we must have recourse to the other means of an
analeptic nature. With respect to stoppage of the respiration, such
as have the foam already at their mouth we must do nothing to,
agreeably to the advice of Hippocrates ; but the others may be re-
suscitated, by pouring into their mouths vinegar and pepper, or
the fruit of the nettle pounded in the strongest vinegar. It is with
difficulty that they swallow it, but they must be compelled; and, when
the redness about the neck is dispelled, they immediately look up and
recover. The same means arc to be used towards those who have
been wrecked in the sea ; and, in fine, towards all those whose respi-
ration has been suspended : for their heat is thereby resuscitated.
' XXVIII. — On Conyzttj Catarrh^ Affections of the Trachea^
and Cough,
All these complaints have this in common, that they are occa-
sioned by the defluxion of a redundant humour from the head to
the parts below. When, therefore, it seats in the nostrils, the
disease is called Coryza ; when in the pharynx and roof of the mouth,
simply Catarrh ; but, when it attacks the larynx and arteria trachea,
8o as to occasion a roughness of the membrane which lines them,
the voice becomes hoarse, and the disease is called Branch us or
morbus arteriacus : these terms being applicable not only to the in-
flammatory roughness occasioned by a defluxion from the head, but
also to that arising from vociferation and inhaling cold air. When
the complaint is protracted, and the defluxion is carried down to the
chest and lungs, it gives rise to bad coughs. And a cough often arises
from an intemperament ; sometimes a hot one, as in fevers ; and
sometimes a cold, as in northerly states of the weather, which is
rather a dry one. Cough is also sometimes symptomatic of some
other disease, such as pleurisy, hepatitis, phthisis, or peripneumonia.
Wherefore Galen relates that, in certain chronic cases of cough,
chalazia (hail-stones) have been brought up from the chest. But
Alexander relates, that a certain heavy stone like that which forms
in the urinary organs was brought up in a chronic cough, upon
which the cough ceased. We, ourselves, have seen a discharge of
stones with vomiting of blood, as we will describe m(»« accurately
when we come to that part. Those who have coryza and catarrh
BOOK THIRD. 287
from exposure to heat have a sensation of heat about the parts,
and a running of acrid and thin humours from the nostrils and
mouth, and there is redness about the face and nose. When they
are occasioned by cold, there is distension about the head and fore-
head, and obstruction of the ethmoid pores, so that the voice does
not resound through the nose, when protracted cough supervenes
and expectoration of phlegm, which is sometimes unconcocted and
fluid, and sometimes green. In some cases fever comes on, which
does not alleviate the complaint when it proceeds from heat, but,
when from cold it promotes concoction.
Thk Curb op Catarrh and Cortza. — When a hot intempera-
ment prevails, those remedies will apply which suit with headacbs
from the same cause. They must use baths, and have a large quan-
tity of hot water poured upon the head. The food most befitting are
spoon-meats, and eggs in a state to be supped, starch, sweet cake,
sesame, rice, almonds, the fruit of the cones of pine, and all confec-
tions from milk. The wines which are drunk should be sweet, and
not old. The lohoch from poppy-heads, and other compound me-
dicines for these complaints, are to be used. When a cold in-
temperament prevails, and the disease is difficult to remove, abati-
nence from food is to be observed, and the head anointed with some
heating and attenuating ointment, such as that of nard or rue. But
the ointment of iris is not only to be rubbed in, but is also to be
injected into the nostrils ; and, internally, they are to be rubbed
with frankincense and myrrh, with oil ; and this more especially
when the Coryza arises from cold. But these are remedied by
odoriferous substances with .burnt linen, or by gith and cumin
burnt and bound up in a linen rag. Let them also smell to the
Cyphi Seleniacum ; and let it be rubbed into the forehead ; and to
it let there be added one of the plaisters which repel inflammation,
such as the Icesian, the Oxera, the Barbarum, and the Athena. For
Catarrh from cold, it will be expedient to drink of cyphi, and to
rub into the chest the juice of balsam by means of unwashed woo] ;
or to apply calefacients to it, along with storax, the ointment of
iris, or that of dill. Let them also use hot and concocting food.
But, when the matter is already concocted, a masticatory will answer
well with them, and detergent ointments (smegmata) to the head,
such as the soap of Constantine, and the like.
Thb Curb of Appection bv the Trachea, or Hoarseness. —
For the complaint called Arteriacus and Branchus, those things al-
ready mentioned will apply ; but, in particular, when an inflam-
matory afiection of the Trachea and Larynx prevails, we must, at
the commencement, use the emplastic remedies, until the inflam-
mation become more moderate ; such as those from Cretan sweet
wine, tragacanth, gum, and starch ; and a decoction of the fatty
dates, and that of liquorice, with rob, until it become of the con-
sistence of honey. And we must use that class of electuaries which
are applied below the tongue called hypoglottides. But, above all
things, the patient, at this period, must abstain from drinking wine ;
but, when the inflammation becomes moderate, he may take some
28S PATJLUS JBGINBTA.
■weet wine. And let him nae those Bpoon-meats which are made from
honey and milk, with starch, and hread of fine flour, and almond
emnkiona ; and let him take butter. When a homour remains fixed
in the parts, he must have recourse to detergent remedies, such as
the porridge of beans, and those things which are prepared from
honey, cabbage, and well-boiled leeks. He may also take the hot-
ter medicines, and those used for the cough, in the rob of dried
figs, frankincense, iris, turpentine, storaz, galbanum, pepper, cin-
namon, cassia, and the like.
On Cough. — Coughs are to be cured by the same method, at-
tending only to this, whether they be occasioned by sympathy with
other parts, such as a defluxion from the uvula or head, and whe-
ther they be symptomatic of other diseases ; in which case, they are
to be disposed of in the manner already mentioned, or as wUl be
described afterwards. An exposition of the compound remedies
follows.
Pills for Catarrh and Cough. — Of storax, of myrrh, of opium,
of galbanum, equal parts. Mix with must, or pound by themselves
in a mortar, and make into pills the size of a tare. Give three,
four, or five, at bed-time, and swallow with some must. These
things are for an acrid and thin rheum. Another : — Of the seed of
henbane, dr. xii. ; of pine kernels, dr. vi. ; of saffron, dr. ii. Mix
with rob or must, and use.
An Elsctuart. — Of honey, oz. i. ; of butter, oz. ss. Boil to-
gether and give ; and let the decoction of hyssop, of figs, of pine
kernels, and of iris, be swallowed.
Pills for mors Invbtbratb Coughs. — Of storax, dr. vi. ; of
myrrh, dr, ii. ss. ; of turpentine, of galbanum, of opoponax, and of
iris, of each, dr. ii. ; of white pepper, of nitre, of henbane seeds,
of the juice of poppy, of each, dr. i. Beat in a mortar without any
liquid, form into pills, and use as formerly directed.
For Roughness of the Wind- pipe. Cough, and Bloody Ex-
pectoration.— Of bitter almonds whitened, xxv in number; of
toasted linseed, dr. iv. ; of tragacanth, dr. ii. ; of pine kernels, xxx
grains ; the yolk of an egg roasted in dough. The tragacanth is
macerated with water, and the whole mixed with must. If the
sound of the voice be broken, mix honey instead of the must, more
particularly when there is any thing to expectorate.
An Arteriac to be kept below the Tongue, for thosb who
have lost the Voice, for Hoarsenkss, and Bloody EbcpRCTOBA-
TioN.--Of tragacanth, dr. vi. ; of gum, dr, vi. ; of myrrh, dr. i. se. ;
of white pepper, xx grains ; of saffron, dr. i. ; of liquorice juice, dr.
vi. ; the flesh of three dates ; of Cretan sweet wine, q. s. The jnioa
of the tragacanth alone put under the tongue answers very wdL
Instead of the juice of liquorice, its decoction boiled down to tibr
proper consistence may be substituted in quadruple quantity.
An Arteriac for loss of Voice, suiting also for Strbnotv
ENiNG the VoicE.—Boil six leeks to a third-part; throw ^
away, but with the decoction mix the juice of alica and honer
BOOK THIRD. 289
boil with them the yolks of three eggs previously boiled^ stirriog
with a branch of dill.
FoK CouQHS. — Of Penny-royal, oz. ii. ; of pine kernels, of bas-
tard-saffiron, of linseed, of each, oz. i. ; of white pepper, oz. iv. ;
mix with boiled honey. Another : — Of hyssop, of penny- royal, of
pepper, of each, oz. i. ; of Macedonian parsley, oz. ss. ; of honey,
a hemina.
For Concocting an Invbtbratb Cough. — Of honey, dr. xvi. ;
of turpentine, dr. ii. ; of galbanum, dr. xiv. Having boiled them
together, and having formed to the size of beans or of walnuts, let
them be sucked. Another : — A dry cough is cured by the arte-
riacs, and also by the drinking of hot water ; for, not being able to
expectorate, owing to the thickness of the phlegm » they are assisted
in so far by diluents. A decoction from hyssop, iris, and pine ker-
nels, also answers with them.
A Trochisk to bb Inhalbd for a Continued Cough. — Of
&torax, of pepper, of mastich, of Macedonian parsley, of each, oz.
i.| ofsandarach, scr. vi. ; two bayberries ; mix with honey ; and
fimu^te by throwing them upon coals, so that the person affected
with the cough may inhale the vapour through a funnel. It an-
swers also with those affected by cold in any wise.
XXIX. — On Orthopncea, Asthmay and Dyspnoea.
Thosb who breathe thick without fever, like those who have run
fast, are said to be asthmatic, that is to say, to pant for breath ; and,
from their being obliged to keep the chest erect, they are called
ortkepnoic. The affection arises from thick and viscid humours be-
coming infarcted in the bronchial cells of the lungs. Dyspnoea is a
common symptom which accompanies these and many other com-
plaints. The indication of cure in asthmatic complaints is to con-
sume the viscid and thick humour by attenuant and detergent
medicines. Wherefore the vinegar of squills will answer well with
them, and the oxymel prepared from it ; the dried squill itself
when triturated with honey, the antidote called Hiera, continued
purging with drastic medicines, and vomiting from radishes. And,
in like manner, the round birthwort may be drank, the root of the
great centaury, the fruit and root of cow-parsnip, the fruit of cala-
mint, 'hyssop, iris, and gith. Put a sextarius of slaters into an
earthen vessel, roast upon the coals ; when whitened, pulverise, and,
mixing with boiled honey, give a mystrum thereof before and after
food. If there be any urgent necessity, before doing all these things,
open a vein and evacuate proportionably to the patient's strength ; and
promote the discharges from the belly by clysters. Externally to
the chest we may apply cataplasms from figs, the flour of iris, and
of bariey, containing rosin, wax, and honey ; and iris and manna
may be sprinkled upon them. Some benefit may also be derived
from raw barley flour, with rosin, wax, iris, and manna. We may
use the more heating ointments, such as those of iris, dill, and rue.
u
290 PAULU8 iEGIN£TA.
But the following application is particularly proper : — Of pumice-
stone, p. i. ; of burnt lees of wine, p. iv. ; of arsenic, p. i. ; of the
8chenanth, p. ii. ; of alcyonium, p. i. ; of aphronitrum, p. ii.; pound,
Bift, mix with the ointment, and with it rub the parts about the
chest, and use emollient ointments for attracting the humours.
A Draught for Asthmatics. — Of poley, of southernwood, of
castor, of ground pine, of ammoniac perfume, equal parts ; mix with
honey, and give. Otherwise : — Some give a spoonful of aphroni-
trum in three cyathi (cupfuls) of honied- water. Another: — Of
aphronitrum, dr. ix. ; of pepper, dr. i. ; of laserwort, dr. ss. ; give
a spoonful in water. Another : — Of castor, of ammoniac perfume,
of each, dr. vi. ; of pepper, xl. grains ; mix with must, and give to
to the size of a bean in honied- water. Another : — Of mustard, dr.
i. ; of the spuma nitri, three oboli ; of elaterium, a dichalcon, (1. e.
half an obolus). Form the whole into eight trochisks, and give
two every two days ; for they will evacuate upwards gently. To
those who are choaked for want of breath give, of aphronitrum, dr.
iii, with three cyathi of hydromel, and sometimes with cardamom,
and it will relieve them immediately. It is also useful in Ischiatic
disease.
XXX. — On Peripneumonia,
Peripneumonia is an inflammation of the lungs, which, for the
most part, supervenes upon violent catarrhs, cynanche, asthma, pleu-
risies, or other complaints, but which sometimes is the original af-
fection. It is accompanied with difficulty of breathing, an acute
fever of the ardent type, weight and tightness of the chest, a wheez-
ing sound in the lungs, and great fulness of the countenance, the
morbific matter rushing upwards like fire. Wherefore the cheeks
appear red, and the eyes swelled, with falling down of the eye-
brows, and the cornea appears somewhat glossy. When the symp-
toms are of a more ardent type, it is to be apprehended that the in-
flammation is of an erysipelatous nature. When the disease origi-
nates from the conversion of other diseases into this, we must reject
venesection, more especially if the diseases be of a chronic nature,
and if blood had been previously let. But in the decline clysters
are to be injected into the bowels, which are moved with difficulty ;
or, when nothing contra-indicates, large cupping-instruments with
scarifications may be frequently applied to the breast and sides. But,
if the peripneumonia was the original affection, and the strength
permit, we must open a vein ; or, if not, we may cup, proportioning
the evacuation to the powers of the patient. Let him take draughts
of the juice of ptisan, or of chondrus with honey, or from bitter
almonds with ^emilago, or chondrus having some sweet drink
mixed with it, such as hydromel, apomel, or hydrorosatum. Fresh
butter to the extent of three spoonfuls is also proper. He must also
drink the propoma of the decoction of figs with hyssop, or of iri
boiled in honied-water, or of powdered iris, to the amount of t
BOOK THIRD. 291
spoonfuls sprinkled apon honied- water. This also evacuates down-
wards. To keep up the strength, he should drink frequently of honied-
water alone, and with pine-kernels, and the seed of cucumhers. The
cerate of privet, having some iris sprinkled upon it, or the cerate
of the oil of rue, and dried iris, or that made of wax, and rosin,
marrow, hutter, hyssop, dried iris, and nard ointment, may he ap-
plied to the whole chest and sides.
XXXL — On Spitting of Blood.
Whbn the spitting of hlood arises from rupture, a great quantity
will be evacuated, and sometimes from an obvious cause, such as a
fall, straining of the voice, and the like ; and sometimes from an ob-
scure cause, such as plethora, or immoderate cold ; for cold, as Hip-
pocrates says, occasions rupture of the veins. If it proceed from
erosion, the discharge of blood will not be rapid, but in small quan-
tity» and will have been preceded by acrid and unwholesome food, or
abstinence, or an acrid defluxion. When it arises from anastamosis,
none of the afore-mentioned circumstances, unless, perhaps, the ple-
thora precedes; but a moistening and heating diet, the use of immode*
rate baths, and living in very hot places, may appear to occasion it ;
and it will neither supervene upon inflammations, nor fevers, nor pains^
as in the case of erosion ; but, on the contrary, they will appear in all
probability to be relieved by the evacuation. If the hsemorrhoidal,
or the menstrual discharge in women be suppressed, the renewal of
these will remove the danger ; and the like good effects will result
from discharges of blood by rupture, when the disease is connected
with plethora, unless the ulcer, or the greatness of the loss of blood
prove injurious. When the discbarge of blood is from erosion, it is
never a favonrable symptom. If it is brought up by vomiting, it is
clear that it comes from the stomach or belly, from which parts it is
sometifioes evacuated by the anus ; but, if by a cough, it comes from
the respiratory organs ; but, if it is frothy and whitish, and is
brought up at intervals, without pain and oppression, it is clear
that it is brought up from the lungs, upon which, in process of
time, a continual fever will supervene, more especially if occasioned
by eroBicHi ; and part of the substance of the lungs, bronchia, or
veins, will be brought up. I knew a certain person affected with
spitting of blood from the lungs, who, after a time, with much
eougliing, and full evacuation of blood, spit up four or five stones,
rough as caltrops, and of the weight of three or four siliquse ; and
he was immediately relieved, but soon after fell into a consumption,
and died. If the discharge consist of phlegm, with a slight cough or
hawking, and the expectoration be frothy and light, you may know
that it comes from the trachea. But, if it consist of black and grum-
oos blood, and there is pain in the part, it indicates that the dis-
charge is from the thorax, being transmitted by the lungs or
broncha. If it be. brought up with hawking, it is by the palate
from the ports about the pharynx. But, if it flow from the head, it
u 2
292 PAUHJS ililGINETA.
18 evacuated with tickling and cough, for it raos down into the.
wind-pipe, and is again brought up. Such discharges are common-
ly preceded by an acrid defluxion, headach, or heaviness. Some-
times the evacuation of blood is from the palate, owing to a leech
having been swallowed, and fixing on some of the parts there. But
of this case we will treat when on the subject of poisons.
Thb Curb. — Those who have a spitting of blood from catarrh
are to be immediately bled (unless the defluxion be very acrid), and
a quantity of blood taken away proportionate to the strength. They
are to have ligatures applied round the extremities, and their bo-
dies, excepting the head, to be rubbed with hot old oil, or with Si-
cyonian. Let them take farinaceous food containing the juice of
some austere fruit, such as that of pomegranate, of apples, or of
pears ; or let these be boiled with it. When going to sleep, give
them the trochisk from amber ; and, on the third day, give some
boiled honey to lick. If these do not succeed, and the disease is
protracted, shave the head, and use the application from wild-
pigeon's dung ; and, after three hours, remove this application, and
put the patient into a bath, taking care not to anoint the head. Then,
having given him spoon-meats for food, administer to him the theriac
antidote at bed- time, and repeat this next day ; and rub in like
manner the whole body, except the head, but to it apply the cerate
from Thapsia, or the like, and again use the spoon-meats. When
the complaint is protracted, apply a cupping- instrument to the
back-part of the head. But, if the defluxion be of a very acrid
nature, we must abstain from venesection, and have recourse to the
food and remedies formerly described when treating of Catarrh, and
such as are now to be mentioned. When the spitting of blood pro-
ceeds from cold, the chest should be warmed, along with remedies
which are of a desiccative nature ; and we must give the medicine
from two peppers, with the trochisk of amber. Those who bring
up blood from the respiratory organs, owing to rupture or anasto-
mosis of the vessels, are to be bled from a vein, unless the discharge
of blood be great. In every case, the patient is to be laid in a well-
ventilated place, upon a steady couch, with his head elevated ; and
he ought to abstain from strong respiration and talking. To the
aflfected parts we may apply sponges soaked in tepid oxycrate ; but
after the seventh-day, unwashed wool, with the oil of roses, of myr*
tie, or of lentisk, sometimes with vinegar, and sometimes with aus-
tere wine ; or, if the discharge be great, we may apply fine flour
and manna, with vinegar, or alum and acacia, or pomegranate rind»
or galls with vinegar, or dates with polenta and quinces boiled in
austere wine. Afterwards we may put on the plaister from wil-
lows, more particularly if the discharge be moderate. But the fol
lowing things are to be taken by the mouth : — Purslain when eate
is of use (but its juice when drunk is more powerful), the flowe
also of the wild pomegranate, the fruit of the bramble and i
ilowers, the fibrous part of the common oak, and the membrane a
der the shell of the acorn (but these are used more especially in f
coetion) ; and yet those of the fagus and ilex are more powerful reo
BOOK THIRD. 293
dies. The Samian aster applies to every spitting of blood, and also
the Lemnian earth, the blood-stone finely triturated with the juice of
pomegranate or knot-grass. The dose of the stone should be one
scruple. The following compound remedies are useful, namely, the
trochisk from amber, that from coral, and that from Egyptian thorn,
also the powder composed of the earth called Samian aster, Lemnian
earth, coral, comfrey, and starch — of each, equal parts. When the
disease is occasioned by erosion, more especially if a catarrh pre-
cede, we may mix half a part of opium. And the composition ad-
mitting of equal parts of Samian aster, agerat stone, and Lemnian
earth, is an excellent remedy when drunk to the amount of two
spoonfuls (cochlearia) in two cupfuls (cyathi) of plantain juice.
Another: — Of Lemnian earth, dr. xvi. ; of Samian aster, dr. xviii. ;
of starch, dr. viii. ; of sarcocoUa, dr. iv. ; of gum, dr. ii. Of this in
powder let one spoonful be taken with two cyathi of the decoction
of dates. Let them also take cold oxy crate, or the decoction of
dates, of apples, of pears, of vine tendrils, or the like. They may
take food, if the strength urgently requires it, about the second or
third hour, but if otherwise about the fourth. Let it consist of
bread that has been soaked in cold water, or halica, or chondrus.
with some of the refrigerant juices, such as those of pomegranate,
or myrtles, or with honey and unripe grapes mixed together, or
eggB softly boiled, or cakes prepared from milk with some astrin-
gent. Of pot-herbs they may take endive, succory, plantain, boiled
with the oil of unripe olives and vinegar. Of autumnal fruits they
may use apples, pears, medlars, pomegranates, and the fruit of the
cornel-tree. When they have no fever, their drink may consist of
a small quantity of diluted wine ; but, when they have fever, of some
of the afore-mentioned draughts, or Cibyratic hydromel. Those
who vomit blood may be treated on the same plan, only they must
abstain from taking food often. They are easily cured, because the
remedies taken by the mouth are applied directly to the parts from
'which the blood flows. When blood is coagulated in the stomach,
let the patient drink of rennet, more especially that of a hare, or
the lixivial ashes of figs with water, or thyme, or savoury with
vinegar ; or evacuations may be produced by means of milk divided
into parts {lac scissum), or of aloes. Those who hawk blood from
the palate must use astringent gargles, and apply to the forehead
and the rest of the head the remedies for bleeding from the nose.
Such is the treatment of spitting of blood, which must be carefully
attended to, on account of the danger from an immoderate discharge
of it ; for, if a great quantity be evacuated, it will bring instant
death, as in the case of a slaughtered animal ; but a continuance of
the complaint threatens a conversion into phthisis. Wherefore,
"when every thing is properly attended to, and the discharge of blood
ceases, their strength must be recruited by getting fish and the feet
and brains of young swine. We must also direct them to get their
l)odies rubbed, to abstain from the frequent use of baths, from
drinking wine, and from mental emotions and venery.
294 PAULUS iEGITHETA.
XXXII. — On Empyema and Phthisis.
Empyema is formed either in the cavities of the chest, or in the
pleura, sometimes arising from vomiting of blood when the ulcer
has not healed (in which case phthisis will soon come on, provided
the blood came from the hmgs), and sometimes from a precursory
inflammation, which has formed into an abscess and burst (as is
sometimes the case in pleurisy), or from a defluxion from the head.
The symptoms of a confirmed Empyema are, weight of the chest,
an intense dry cough with pain, and sometimes with a fluid, in
which case, they seem to experience an alleviation. At the com-
mencement the fever is weak, irregular, and difficult to perceive ;
but, when the abscess is about to burst, they have more violent fe-
ver, attended with rigor ; and, in speaking, their breathing expe-
riences interruption. When the abscess bursts, matter is brought
up, sometimes pure and sometimes feculent : sometimes it is dis-
charged upwards, when it is attended with more danger ; and some-
times downwards, in which case the matter is sometimes translated
to the stomach and bowels ; and sometimes to the bladder, the me-
tastasis taking place by certain vessels. All along they have hectic
fever until the ulcer becomes clean ; and, if this do not speedily take
place, the Empyema is converted into Phthisis from the lungs un-
dergoing ulceration. When this takes place, the cheeks are livid ;
there are copious sweats about the forehead and neck ; the flesh is
' melted, the nails bent ; and they appear glossy, white^ or pale.
When the disease prevails, the belly is disordered, the hypochondria
drawn upwards ; they labour for the most part under thirst and a
loathing of food ; and the expectoration is very fetid.
The Cure. — Our first object, therefore, ought to be, to assist the
concoction of the abscess, which may be attempted by fomenting
with sponges, and applying cataplasms made of barley-flour, with
dried figs boiled, some rosin, pigeon*s dung, nitre, and mallows.
The rupture of the abscess is promoted by l)iing upon the side which
is not aflfected. Let them drink at intervals honied-water, and the
juice of ptisan with honey. Those who are stronger may likewise
drink the decoction of hyssop and thyme with honey. Ekiting
pickles also forwards the breaking of the abscess, and likewise the
pills from the colocynth hiera, taken at bedrtime. When the pus
begins to be discharged, give again the decoction of hyssop, iris
and liquorice boiled in honied-water, or liquorice triturated with
sesame; and apply a cataplasm of fine flour, boiled in honied-
water and oil. When the ulceration is difficult to cleanse, we must
use the compound remedies, such as that from horehound, either
the simple or the compound one; that from tares; and those called
Dodecatheon, and the medicine of Philoxenus. When it is con-
verted into phthisis, we may give the headed leek, dissolved in
draughts of chondrus or ptisan, and let them be twice boiled by
themselves. Let the water which is drunk be rain, and honied-
water made from it. At the beginning of the remissions, appl
BOOK THIRD. 295
cataplasms of linseed and fine flour, with the decoction of fenugreek,
or mallows, oil, honey, and the leaves of marshmallows. In pro-
cess of time we may have recourse to cerates, such as those from
butter, oil of privet, oil of bays, and iris. The plaster of Mnasseus
is also to be used. When there is a defluzion from the chest, that
made of willows may be applied to it. They may also take the
simple propoma, mentioned already for empyema, and some of the
compound ones. When a violent cough prevails, mix thyme and
hyssop, along with the juice of liquorice, in well boiled honey ; and,
luiving formed them properly, give to be retained under the tongue.
The antidote of Mithridates, at intervals, will likewise suit with
them, as also that from vipers. But the best remedy is the Arme-
nian bole taken in a draught, and the antidote Esdra is not at all
inferior to the aforesaid.
XXXIII.— 0^ Pleurisy.
Plburibt, properly so called, is an inflammation of the mem-
brane which lines the ribs, and is attended with difficulty of breath-
ing, cough, continual fever, and pain shooting to the clavicle and
hypochondrium. You may distinguish Pleurisy from inflammation
of the liver (for in it there are all these symptoms), by the pain in
Pleurisy being pungent, and the cough being sometimes without
expectoration (when it indicates that the disease is not yet con-
cocted), and sometimes with expectoration, the appearance of
which indicates the nature of the humour that occasions the com-
plaint ; for, it is red and tinged with blood when a fulness of blood
is the cause ; yellow and palish when caused by yellow bile ; white
and frothy when from phlegm ; and blackish when from the melan-
cholic humour. And the pulse is hard and serrated. But, in in-
flammation of the liver, the pain is not pungent, nor is the pulse so
liard ; and the cough throughout is dry and without expectoration,
and tJie face appears paler. Pleurisies from inflammation of the
external muscles (which are not, properly speaking, pleurisies) are
xmaccompanied with cough and expectoration, nor is the pulse
liard ; and, if one touch the part afiected with his hand, the pa-
tients feel pain ; and, if not resolved, the swelling is converted into
pus, which may be evacuated externally by an incision ; whereas
pleurisy from inflammation of the membrane which lines the chest
liaa not this termination. For, if it do not discharge the em-
pyema either internally or externally, it terminates in peripneu-
monia.
Thb Cure. — If the pain shoot to the clavicle, we must straight
way open a vein ; or, if to the hypochondrium, we must purge
downwards. Physicians of late, in all cases, have recourse to ve-
nesection, apprehending, I suppose, the disturbance occasioned by
purging. When the strength prevents us from having recourse to
either of these remedies, we must use stimulant clysters ; and, if
the pain is moderate, after the clyster we may give honied-water,
296 PAITLUS ^GINRTA.
and the juice of ptisan and of chondnis. When the afiection is on
the decline, we may add to the juices leeks or calamint ; and the
patients may get the seeds of penny-royal and nettle, with honey, as
a linctus. When the pains are violent, after the evacuatioDt they
must be soothed by the application of hot wool, or of sulpharated
wool, or by fomentations of millet and flour in a bag, or by means
of hot water or oil in a bladder. Unwashed wool may be applied with
oil ; and wine, containing an admixture of sea- water, or salt, may
be added to it. Or, we may apply a cataplasm, formed of the me-
dicine from seeds, with the decoction of camomile and marsh-
mallows, or of dried figs» iris, wormwood, and some honey, with oil
of nard. About the fourth day, give spoon-meats for food, with
some honey ; but, after the sevenUi day, we are to give a linctus
of almonds and nettle seeds, triturated in honey, or Uie linctoa of
butter and honey pounded together. And we are to use the hypo-
glottis (electuary) of boiled honey. And we must apply to the
affected parts the fetid epitheme — that from sweet marjoram, and
the me plaister. The bulbi, applied with axunge, are often an
effectual remedy ; and tliey may also be administered in a clyster
with butter and turpentine. Among the most powerful remedies is
the linctus from pine kernels and bitter almonds, linseed, pitch-
fruit, and starch, in equal parts, with honey. When they are
troubled with sleeplessness, it will be proper to give a linctus of
poppy-heads ; and we may use the antidote called Athanasia, and
those composed for this purpose. When the disease remains after
the fourteenth day, we must cup them, and keep them upon a spare
diet ; and then, when the disease is on the decline, we may make
them take the bath, avoiding the cold, and allow them to use a
more nutritious diet. If the inflammation of the pleura be not re-
solved, but appear to be converted into pus, we must have recourse
to the remedies formerly mentioned.
Foa Fains of thb Sides without Fbvbe. — ^Pains of the sides
without fever are cured by bdellium and costus, mixed with the
ashes of burnt cabbage leaves and tallow. For, this remedy is
powerfully discutient.
XXXIV. — On Affections of the Heart.
Whbn the heart itself is primarily affected, the case is far beyond
all medical aid, occasioning sudden death ; and so also, in the in-
flammations and erysipelas of it, strong distemperatnres in very aente
fevers, and hemorrhages when it is wounded, especially in the left
ventricle. When it is affected sympathetically with the brain, the
liver, the orifice of the stomach, and from sorrow, fear, and many
other causes, it brings on the affection called syncope, being a sud-
den collapse of the vital powers, indicated by prostration of
strength, dcliquium animi, a small pulse, coldness of the extremities,
and copious perspiration. When tliis affection is of a violent
nature, it aUo h irreiucdiablc ; hut, if the strength stands out, it
JBOOK THIRD. 297
may sometimes be relieved. But strong palpitations of the heart
often arise from a fulness or effervescence of its blood. When,
therefore, the heart is over-heated, it renders the respiration large
and dense ; but, when it is too cold, the respiration is small and
rare. The complete cure of syncope of the heart, when it occurs
among the symptoms of fever, we have treated of in the Second
Book. This only may now be added, that, when the collapse pre-
vails after friction and ointments have been applied to the extremi-
ties, and after purification of the floor, and other cooling means,
we mast sprinkle upon the parts of the body which are sweating,
powdered m3rrtle, Cimolian earth, or amber, or pomegranate rind
with manna, or Samian earth with gum ; and cataplasms of mustard
or pellitory, or adarce, are to be applied to the cold extremities, as
far as to the groins and arm- pits. The food should be bread out of
water, or out of cold diluted wine, s wines' feet, and the joints and
sncmt, fowls, — all these things in a cold state. On the head and
forehead is to be rubbed the juice of unripe olives, or some astrin-
gent application, with gum, and the decoction of roses ; and a cata-
plasm is to be applied to the h3^ochondria and stomach, formed
from dates, roses, the flower of the wild vine, acacia, hypocistis, and
alum.
On Palpitation of tbb Hbart. — " I knew a certain person,"
says Galen, " who suffered an attack of palpitation of the heart
every year in the season of spring. Wherefore, having for three
years experienced benefit from venesection, in the fourth he antici-
pated the attack by getting bled, and escaped from it, and did so
for many years afterwards,*^ using at the same time a suitable diet.
And yet he died before attaining old age, as every other person in
this complaint does, some being suddenly cut off in acute fevers by
Syncope ; but some of them without syncope, being unexpectedly
deprived of life, as if by apoplexy. The majority of those who are
thus affected do not reach the fiftieth year of age, but pass the
fbrtietii."
XXXV. — On Affections of the Breasts.
Aftxr child-foirtfa, the milk frequently being converted into
csheese in the breasts, produces inflammations. Wherefore at first
^^e may use these applications : — Having squeezed a soft sponge out
of tepid oxycrate, apply it to the breasts, and bind it on in the pro-
per form ; or use dates triturated in oxycrate with bread, or a
Vrbole egg with rose-oil and some cerate ; or alum, flea- wort, with
Coriander and purslain, may be applied in the form of a cataplasm ;
cir, apply the Fire stone triturated with cerate, and bind it on. When
'^here is distension or thrombus in the part, apply a cataplasm of
V)read with water and honey, or with wine and honey ; or bread
"With the green herb perdicias (polygonum maritimum?), along with
derate twice a-day ; or bean flour with hydromel, or sodden must,
teut, if they cannot bear the weight, we must use an embrocation of
298 PAULUS iEGIN£TA.
hot sweet oil by means of soft wool. But we must foment them
with the steam of hot water, or a decoction of fenugreek, or
of marshmallows, or of linseed. And we are to apply to them a
cataplasm made of fine flour with linseed, or fenugreek with hydro-
mel, or sesame with honey, or pounded butter. But we must inter-
dict sucking of the breasts, because it only attracts more milk to
them. When the inflammation is on the decline, we may apply the
following cerates : — Boil beet in oil until it is softened, throw it
away, but add to the oil a moderate quantity of wax, and use.
Another : — Mix the red parts of ten raw eggs in a cerate consisting
of wax, oz. ii. ss. and of rose-oil, oz. iv. ; stir with a spatula, and
add as much salt water as it can receive, and then again stir with a
spatula, and use. For hardness of the breasts, the composition
from honey is applicable, and all emollient applications. When the
swelling is converted into pus, we must use those applications which
have been mentioned for parotis, and those that will be mentioned
afterwards for apostemes.
From Arohigbnbs, for sprbading Ulcbrs of thb Brbasts
ATTBNDBD WITH Malignitf. — Of good Adriatic wine, xx. sextarii;
of the sumach, lb. i. ; of cypress balls, lb. i. ; of black galls called
omphacita, oz. vi. ; of cassia, oz. vi. ; when bruised, macerate in
wine for ten days, then boil down to one-half, stirring with a cypress
spatula ; then throw away the herbs ; and, when the juice is boiled
to the consistence of honey, lay it up in a glass vessel. Use it for
spreading ulcers, undiluted, or, if it is too thick, let it be dilated
with wine. It is so made as to apply to spreading ulcers in the
breasts, to runnings of the ears, foul defluxions from the gums,
and dysentery. When diluted with milk it acts as a paregoric in
soothing pain. Other kinds of ulceration of the breasts must be
treated like ulcers in general.
Prbsbrvativbs of thb Brbasts. — Having pounded cmnin with
water, apply to the nipples, then lay upon the breasts a sponge
squeezed out of oxymel, and bind it with a bandage. After three
days, having taken away the cumin, put on a cataplasm of the bulbous
roots of the lily upon the nipples, and, having bandaged it, let itTe-
main again for three days, and do the same three times a month.
Another : — Apply powdered hemlock for nine days, and the sponge
externally, as mentioned above ; and, after an interval of a few
days, repeat the same. The rubbings from the Naxian whet-stone
act as a preservative of the breasts of virgins.
XXXVI. — For Fetid Smell and Sweating at the Arm-pits.
Of liquid alum, p. ii. ; of myrrh, p. i. ; dissolve in wine, and
use. Another: — Plunge heated Molybdsena into h*agrant wine,
triturate with the wine, adding a little m3Trh until it become of
the thickness of the sordes in baths, then use. Another : — Of
litharge, dr. xvi. ; of myrrh, dr. ii. ; of amomum, dr. i. mix with
BOOK THIRD. 299
wine. Another : — Of liqaid alum, dr. viii. : of amomura, of myrrh,
and of spikenard, of each, dr. iv. ; tritmrate with wine, and use.
XXXVII. — On Affectiom qfthe Stomachy of the parts in the
Hypochondiiaf and of the Belly.
Thosb complaints which occur in Fevers, such as loathing of
food, hulimia, the canine appetite, atony of the stomach, deliquium
animi, thirst, hiccough, nausea, and syncope, have heen treated of
sufficiently in the Second Book, and it would he oat of place to say
more ahout them. But inflammations of the orifice of the stomach
and of the liver require the admixture of astringents ; for, if treated
hy the relaxant method alone, it will occasion danger to the life. It
will he necessary, then, whether oil he affused on the part, or a cata-
plasm be applied, to add some of the astringents to it, such as
wormwood, or the nard ointment, or that of apples, or of quinces
may be boiled in it. The following is a cerate which we frequently
use : — Of white wax, oz. i. (but if in summer, dr. vii.) ; of aloes
and mastich, of each, dr. i. ; add of the oil of unripe olives, or of
apples, and of nard, when going to use it, as much as will be suf-
ficient to g^ve it consistence. Or, if the stomach require greater
astringency, as not being able to retain the food, mix also of oil of
unripe olives, dr. i. ; or of the juice of wormwood an equal quantity ;
and, thirdly, of the juice of hypocistis, of wild vine, and of sumach.
We must make the quantity of the cerate proportionate to the num*
her of the other medicines. When the inflammation becomes pro-
tracted and hard, we must apply more complicated remedies, con-
taining aromatic, emollient, and discutient ingredients, such as that
prepared from melilot> the Philagrianum, and the odoriferous one.
And a collar of green jaspar appended from the neck, so as to touch
the stomach, is of great use. In hot intemperaments of the stomach,
or ardent aflections of it with prostration or deliquium animi, or
anorexia from any other cause than fever, give cold water with the
Juice of unripe grapes, or the decoction of quinces, or of vine shoots,
or the powdered seed of cucumber with cold water. Apply to the
stomach a bladder filled with cold water, or the shavings of gourd.
And the pills called Adipsa are to be given, as described when
treating of thirst* The following medicine is proper for cooling
and strengthening a watery stomach : — Of green rose leaves, dr.
vi. ; of liquorice juice, dr. iv., mix with sweet wine, and make into
a medicine, to be allowed to melt under the tongue. When, on ac-
count of a gross phlegm, medicines are required to heat and incide
it, the following one will be useful : — Of the rind of fennel root. oz.
ii. ; of vinegar, a sextarius and a half ; of aloes, oz. iii. ; of honey, '
lb. iv. ; the roots being boiled in the vinegar, are to be squeezed
ont and thrown away, and, honey being added, it is to be boiled to
a proper consistence, and then powdered aloes sprinkled upon it.
Give three spoonfuls of it with water. Some prepare it without the
aloes. The composition from calamint is also proper for such cases.
300 PAUJL.US iEGlNETA.
When the food turns acid on the stomach, give in water for drink
a dram of coriander seed sprinkled upon it like polenta, or one
spoonful of mastich, or two spoonfuls of the seed of the white let-
tuce. The following is a compound medicine : — Of pepper, dr. i. ;
of the seeds of dill, dr. iii. ; of cumin, dr. iv. ; triturate, and give at
bed time one spoonful in diluted wine. Those who form black
bile, and have the stomach inflated, may, during the exacerbations,
apply to it sponges soaked in the strongest vinegar, after which, if
the complaints continue, alum with pulverised copper may be ad-
ded to honey, and applied. Let them drink the juice of endive, or
let mint be sprinkled upon the draught. When the stomach is in-
flated and distended, mix a moderate quantity of honey and pepper
with the decoction of calamint, and give. For overturning of the
stomach, take of the juice of the kernels of the unripe pomegranate
p. iii. ; of the juice of mint, p. i. ; boil until it thicken, and give a
mystrum of it before food.
For Salivation op the Stomach. — Rinse the mouth with vine-
gar of squills, the sauce of pickled olives, or the decoction of the
green leaves. Or, a very small quantity of the same may be swal-
lowed. A still more effectual remedy is aloes dissolved in water.
For those who cannot retain their food (who were particularly called
stomachics by the ancients), mix with honey the flour of fenugreek,
and the dried seed of mallows in powder, and apply. The cerate of
wax, the lees of oil of iris, and castor, is also proper.
On Anorbxia. — Anorexia is a loathing of food, either ^m the
prevalence of an in temperament in the stomach, or a collection of
humours. You may know a hot intemperament by the thirst, by
the fetid and feculent eructations if compelled to take food, and
from the circumstance that cold and intractable substances are moM
easily digested ; and a cold by the opposite, for they neither have
thirst, nor can they endure cold things, and they have sometimes
acid eructations. Of those who have anorexia from humours, they
who suflfer from thin and sharp humours, have gnawing pain at
the stomach, and are more affected with nausea and thirst. When
the humours become putrid, they sometimes have fever. When
they suffer from thick and viscid humours, these for the most part
neither occasion acute pain nor thirst, but the common symptom of
all these cases is nausea. Wherefore, if the humours are contained
in the cavity of the stomach, they vomit them up ; but, if they are
absorbed and infarcted in its coats, they have nausea only, but do
not vomit, unless it be when they have taken food. Those, there-
fore, who have anorexia from a hot intemperament, should take
cooling things for diet, more especially such as are prepared from
vinegar. Wherefore give them bread that has been soaked in oxy-
crate, or oxycrate itself tQ drink, and oxygal (vinegar and milk), and
that which is called Melca by the Romans (it is a condiment from
milk), endive, lettuces, and sometimes cold water : all these mode-
rately, according to the degree of the prevailing intemperament ; for
the immoderate use of them is not only not beneficial, but often ren-
ders the complaint utterly incurable. When the affection is connected
BOOK THIRD. ^1
with coldness, it is to be cured by the opposite remedies ; where-
fore give to drink old wine and prepared wine, bydrogarum, and
the decoction of anise, rue, and Macedonian parsley, and pepper,
in hot common water ; or the composition from the three peppers,
or that from calamint. You may give also the Theriac from vipers,
which is also not inapplicable to those who loathe food from a coU
lection of humours. Garlic, both as food and as medicine, is ap-
plicable to them. When the anorexia proceeds from a collection of
humours, you may evacuate such as are thin and sharp, either by
vomiting or purging downwards, and they may readily be made to
vomit, by drinking beforehand tepid water, or hydromel diluted with
a large quantity of water. But it will be better to give previously
some moistening food, such as the juice of Ptisan, or the yolks of
eggs. How to produce easy vomiting has been explained in the
First Book. But, if the patient be hard to make vomit, it will be
better to determine the matter downwards, having previously di-
luted their system by means of plenty of mild food. The cathartic
medicine may either be the Picra from aloes, that from quinces,
which also admits of scammony, or that from Rhodomel. If it be
possible without the scammony to evacuate by a large dose of aloes,
it will be better, because the scammony is bad for the stomach.
When the anorexia proceeds from thick and viscid humours, you
may cure them by attenuating and incisive remedies, such as oxy-
mel, and the preparations from it and brine, as cappers, olives,
mustard, and the like. The remedies recommended for anorexia
from a cold intemperament are not inapplicable to these, and more
particularly after evacuation. You may evacuate them by the oxy-
mel called Julian. Externally you must use those unguents and
emollient ointments which have power to warm and strengthen
the stomach, such as that from the unripe grape, that called Mar
ciatum, and all the common ointments ; also such epithemes as the
Baium, the Odoriferous, and the like. They ought particularly to have
recourse to exercises and friction. When dyspepsia and anorexia
arise from a cold and liquid humour, or such an intemperament,
the medicines composed from quinces will be applicable to them,
I mean that called Meloplacuntion, that from the juice of apples,
and that from the flesh of them, and that which is prepared from
the Citron. Also the Malagmata or emollient unguents, such as
the Marciatum, that from the juice of the unripe grape, the Baium,
Polyarchiura, and the like. When there is an ulcer in the stomach
or bowels, the patient must abstain from all acrid food and drink,
and use such remedies as are of a soothing nature^ such as draughts
without oil, and those from starch, Samian earth, Lemnian earth,
and milk, or a small quantity of honey, so as to purge without grip-
ing. A convenient epitheme is prepared from dates, quinces, and
polenta, and a cerate from quince ointment, or rose-oil with am-
moniac and frankincense ; and also the epitheme of Nileus, the
plaster from willows, and the Icesian may be used. You may
know that an ulcer exists by blood, pus, or the scabs of a sore
being vomited up.
302 PAULUS iEQINSTA.
For those whose Stomachs are Enervated and in a state
ov Atont, and who, for that reason, do not Digest their
Food, or Vomit it up. — Of aloes, of masucha, of mastich, of sto-
rax, of each, oz. ii. ; of wormwood, oz. iv. ; of the flowers of the
wild vine, oz, iii. ; of Gleucine oil, oz. vi. ; of quince ointment, oz.
iii. ; of wine, q. s. Some also add of cyphi and roses, of each, oz.
ii. These things, heing powdered, are received upon purple or wool,
and applied to the stomach. But some, hy adding of wax, oz. vi.
make an epitheme of it.
For Iliac Affections of the Stomach, that is, strong and
Spasmodic Pains. — ^The trochisk of the Amazonians is the best me-
dicine in this case. An account of it, and of the ingredients which
enter into the composition of other compound remedies for the sto-
mach, you will find in the last Book, where compound medicines are
treated of.
XXXVIII. — On Inflation of the Stomach.
The formation of flatus in the stomach arises from the juices or
food being converted into vapours by a gentle heat. For cold, as
it does not attenuate and dissolve, does not engender flatulence ;
whilst a violent heat not only attenuates, but likewise dissipates,
•nd thus prevents the formation of flatulence. But a lesser degree
of heat dissolves and changes the food, but not sufficiently, and
hence flatus is gendered. Wherefore, we must attenuate them by
calefacient medicines, — ^boiling in oil the seed of cumin, of parsley,
of cow-parsnip, and of carrot. When the affection partakes of cold,
you may boil rue, bay-berries, gith, and fennel, in the oil, and mix
bitumen and oil of bays. But, if the pain be attended with inflam-
mation, instead of calefacients, you may use relaxants, making a
decoction of dill, and mixing with it the fat of a cock and of a
goose. Those who have flatulence may be relieved by the decoc-
tion of a fasciculus of poley, or a decoction of calamint, having a
small quantity of honey and a dram of pepper mixed with it.
These remedies must be applied when the pain is violent : but, if it
is moderate, fomentations from millet will be sufficient. But a
large cupping-instrument that will comprehend the navel, often re-
moves the sjrmptom at once. Castor also is of use to them, when
taken in a draught with oxycrate, and when applied externally with
Sicyonian oil ; and it also cures flatulence when attended with tor-
mina. But the ancles of a swine burnt, and taken in a draught,
CTure tormina and flatulence; and the round birthwort does the
same. Pains from obstructions of the bowels, or flatulence arising
from thickness of the humours, or from cold, are relieved by drink-
ing undiluted wine after food. And, if sleep follow, it completely
removes these complaints.
BOOK THIRD. 308
XXXIX. — On Cholera.
Cholera is an immoderate disorder of the belly, with discharges
upwards and downwards, arising from continued indigestion of the
food. Persons are affected with indigestion • sometimes from the
badness of their food, and sometimes owing to a redundance of de-
praved humours. Wherefore, if the patient be seized with nausea
and lancinating pains, while the food remains in the stomach un«
digested, we must order him to drink tepid water, and to produce vo-
miting by putting his fingers or feathers down the throat. We must
also encourage the discharge by the bowels. After the evacuation
of the superfluities, he must take rest, and apply warmth to the
hypochondrium, by means of sweet oil, with some wine ; or by the
oil of mastich, or of spikenard, if it is winter. And he must be
allowed to sleep. After digestion has been accomplished, let him
have recourse to baths and wholesome food. When the discharge
is immoderate, it will be sufficient, in the beginning, to try those
things which 'are mentioned in the Second Book for disorder of
the belly. But, when the discharge continues, and the belly col-
lapses, and the pulse gets small and dense, we must apply a cata-
plasm of dates, with flowers of wild vine, acacia, the juice of
hypocistis, and pomegranate rind. For drink, give a cupful of
moderately- cold water to swallow; or, what is still better, a decoo«
tion of roses, of the flowers of wild vine, of sumach, or of vine-
shoots ; or, we may give the juice of an acid-sweet pomegranate,
sprinkling upon it a little mint. When the excretions are more acrid,
and beat and thirst come on, we must give the seed of cucumber,
wi& tiiree cupfiils of water ; and succory and lettuces boiled in ozy*
crate fire to be used for food. When the discharge cannot be stopped,
we must administer some of the austere wines ; if the patient be free
of fever, the Palmatian, the Amineean, or palm wine, or that from un-
ripe grapes, with honey ; but, when he has fever, pomegranate wine,
or myrtle wine, or Cibyratic hydromel for drink, and along with
crumbs of bread, alica, or chondrus. If he loathes frumentace-
oas food, he may chew some sammer • fruit, or medlars, pears,
quinces, or pomegranates, but he must spit out the fleshy and hard
parts. When he cannot retain the food, let a large dry-cupping
instrument be fastened over the stomach, and, while it is on, let
some of the afore-mentioned food be taken. For the spasmodic
contractions, apply to the muscles hot rags dipped in oil, and liquid
cerates, containing some castor and Sicyonian oil ; but, before ap-
plying them, let hot water be poured upon the legs. If he cannot
get sleep, we must have recourse to the remedies recommended for
watchfulness ; and, if his strength permit, he may take a potion
from poppy-heads. When the disease is on the decline, he may
be put into a bath, and recruited with chickens, pigeons, the feet of
swine, or the like. Diarrhoea, being a corruption of the food, for
the most part ceases spontaneously, if no more food be taken until
after the complete digestion and evacuation of the corrupted mat-
l4 PAULUB .BGINBTA.
TB ; but, if it continue, we must use the remedies applicable to
Jholera.
XL. — On Lientery and Cmliac Affection.
Thbrb are two varieties of Lientery, the one arising from super-
ficial ulceration of the intestines, and (according to some) from a
cicatrix occasioned most frequently by dysentery or other deiluxions ;
and the other from an atony of the retentive faculty of the bowels,
the second variety being in my opinion connected with the Coeliac
Affection ; for, in it the stomach being unable to concoct and dis-
tribute the food, it is discharged downwards in a smooth, undigest-
ed, and liquid state, the stomach in all cases labouring under a
defluzion. But in lientery the passage of the food is quick, and the
indigestion more strongly marked ; so that the appearance of the
food which has been taken is preserved, and, by these circumstances,
it is more especially distinguished from coeliac affection. Where-
fore we must apply cataplasms of linseed with dates. And lentisk
and bramble boiled with oxymel is a very effectual remedy ; but,
when there is flatulence of the bowels, we must mix some cumin,
dill, and rue. If the defluxion increase, we may add quinces, alum,
acacia, hypocistis, galls, some or all of these. Cerates also made
of myrtle oil with some astringent wine are useful, and the calefia-
cient epithemes from the bay-berries, or from seeds. But that from
the flowers of wild vine, that from grape stones, and that ascribed
to Antyllus, are more astringent. But the one called Erythrian is
wonderfully efficacious. When the disease is protracted, we must
have recourse to a dropax along the abdomen, and the cerate from
mustard, or mustard itself. The drinks which are taken should
be simple, containing plantain seed, or the seed of dock, or the
rind of pomegranate, or dried services, or dried unripe grapes from
the Aminsen vine, to the amount of three oboli; which things,
when there is no fever, are to be taken in six cupfuls of an austere
wine, but when there is fever in rain water. It will injure the sto-
mach less if tlie dried crop of hens be sprinkled upon the drink.
But diuretics, such as parsley, maiden- hair, and the Uke, occasion a
matastasis of the fluid ; and, in like manner, the compound ones, as
that of Poly ides (it is the Sigillum), the trochisk from amber, that
from Egyptian thorn, the one called Clidium, and that from seeds.
The following one is most excellent : — Of the seed of the wild dock,
oz. i. ss. ; of plantain seed, oz. i. ; of the juice of the hypocistis,
dr. vi. ; of gum or acacia, dr. iii. ; add to a decoction of the juice of
quinces boiled to a third-part. Another : — Of cumin, of pepper, of
Syriac sumach, of the flowers of the wild pomegranate, of each, oz. i.
ss. ; of pomegranate rind, oz. i. ; of laser-wort, oz. ss. ; either
sprinkle a dram of it dried upon the drink, or mix with oxymel, and
give morning and evening. Another : — Of black myrtle, a spoon-
ful and a half ; of anise, of dried roses, of the flower of wild vine,
of each, half a spoonful ; of dates, xx in number ; make trochisks.
BOOK THIRD. 305
and give a dram with water or diluted wine. And the theriac
from vipers is also an excellent remedy for them. When the dis-
charge is acrid and bilious, the food should be from chondrus, rice,
alica, and the like ; bat some of the astringents should be boiled
along with them, such as pears, apples, quinces, medlars, and such
like. Boiled milk is also proper. The drink should be either a
light watery wine, or some of the sweet potions. If the discharges
consist more of phlegm, we may change the diet to the opposite
kind, mixing the seeds of some of the stomachic vegetables, anise,
cumin, or the seed of parsley. The dried lentil twice boiled is
often of use to them, when eaten with a little vinegar or oxymel, and
cabbages likewise twice boiled ; but it is better to make the second
boiling in oxycrate. They should drink some of the older and
more heating wines.
XLI. — On Tenesmus,
Tenesmus is sometimes the precursor of dysentery, but often it pre-
vails alone for a short time, and then ceases. The affection is an irre-
sistible desire of evacuation, discharging nothing but some bloody or
mucous matter, which is the cause of the whole complaint, being an
(edematous inflammation in the rectum, which creates the impression
of faeces lodged in the intestine, and a desire of evacuation. And
Galen relates, that a stone has sometimes been discharged by the
anus in attacks of tenesmus. But tenesmus often arises in conse-
qaence of faeces being retained in the small intestines, and is in-
creased by astringents and obstruents, but immediately removed by
acrid injections, such as honied- water with salts, or by any of the
emollients taken by the mouth, such as damascenes, dried figs, the
herb mercury, or the whey of milk ; for, when the fa?ces are evacu-
ated, the complaint immediately ceases. When the tenesmus occurs
without such a cause, it will be proper to allay the inflammation by
barley-flour heated, the embrocations from wine, myrtle-oil, rose-
oil, or the oil of unripe olives, applied to the loins and lower
belly. The mucous matters shut up in the rectum must be cleared
away by an injection of honied-water. And salt and water often
when injected effects the purpose, or six drams of salts in a hemina
of hot water. But we must mitigate the pain and intense suffer-
ings by sitting in a hip-bath of fenugreek, mallows, or linseed.
Sometimes the following hip-bath will effect the purpose : — Of
bramble, of myrtle, of the flowers of the pomegranate, of bays, and
of green cypress shoots, mixing these in equal parts, boil in water.
It is the Marcellian. When the inflammation and irritation are
deep-seated, we must use injections of some of the frumentaceous
juices boiled with some of the astringents. And sweet oil injected
and retained for several hours has the effect of removing the violent
pain When the desires to go to stool are frequent, we must apply
a ball of warm threads to the anus, or warm bran in a bag, or
sponge, or some such thing.
X
306 PAULUS iEGINETA.
XLII. — On Dysentery,
Dysbntery is an ulceration of the intestines, sometimes arising
from the translation of tenesmus, or some of the disorders of thie
bowels formerly mentioned, and sometimes being itself the primary
affection ; and it is attended with evacuations, at first bilious, and
of various colours, then, accordingly, bloody, and at last ichorous,
like that which runs from dead bodies. Dysentery, arising from
black bile, is necessarily fatal, as indicating an ulcerated cancer. If,
therefore, the appearances of ulceration be discharged, mixed with
the fseces, and attended with pains and tormina, you may be sure
that the ulceration is seated in the small intestines, and is to be re-
medied by medicines swallowed by the mouth ; but, if the fseces be
passed unmixed with the blood, it is an affection of the large intes-
tines, and will yield rather to clysters. When there is a great dis-
charge of blood by itself, the disease is called the Bloody Dysentery.
Sometimes the blood which is discharged is blacker than natural
and shining, owing to the liver's not digesting properly the food
which is sent to it ; and, owing to an atony of the retentive or al-
terative faculty of the stomach, it is discharged from it like the
washings of newly-killed flesh. This is called Hepatic Dysentery,
and will be treated of along with the affections of the liver.
In general, therefore, we must use those things which were re-
commended for Cceliac and other preternatural evacuations ; but, in
particular, the Lemnian earth cures a spreading dysentery when
drank or injected, the intestine being previously washed out with
honied- water, and afterwards with salt water; and the juice of
purslain is proper for dysenteric affections when drank, or the purs-
lain itself when boiled in oxy crate and eaten. Plantain also is pro-
per, and the fruit and leaves of the bramble, the decoction of the
root of marsh-mallows, the herb horse-tail drank in water or wine,
and the juice of it, the unripe fruit of the mulberry dried, and, still
more, bramble-berries when similarly dried. Eggs boiled with
vinegar and eaten dry up fluxes of the belly; but it will answer
better if, mixing with them some of the articles which are good for
dysentery, you fry them, and give to eat. The wine of unripe
grapes is most useful in these cases, and the red sumach, and the
juice of it, the rind of pomegranate, galls, grape-stones, medlars,
myrtles, cornels, the ashes of snails roasted whole. The following
is a compound medicine : — Of the ashes of snails, p. iv. ; of galls,
p. ii. ; of pepper, p. i. : reduce to a fine powder, and sprinkle upon
the condiments, or give to drink in water, or a white watery wine.
It greatly helps dysenteric patients, when the ulcers are not putrid.
But the dried dung of dogs who have eaten bones, when drank in
milk which has been curdled by having heated pebbles put into it,
is of great service. The following are compound remedies : — The
trochisk from Egyptian thorn, that of Philip, that from hartshorn,
that from seeds, and the Trigonus. The pills from Macer are ex-
cellent remedies. The following is an admirable one : — Of opiam,
BOOK THIUD. 307
of saffron, of Indian Lycium fcatechu ?), of acacia, of sumach, of
frankincense, of galls, of hypocistis, of pomegranate rind, of myrrh,
of aloes, equal parts; give in water to the amount of three oholi.
Another : — Of sumach, dr. viii. ; of galls, of pomegranate rind, of
each, dr. iv. : give a spoonful in wine. Another : — Of sumach, dr.
viii. ; of galls, of acacia, of gum, of each, dr. ii. ; of opium, dr. i. :
give one dram in diluted wine. This linctns will suit with them : —
Of black m3nrtles, one sextarius ; of Syriac sumach, one sextarius ; of
Theban dates, lb. ii. ; of the flesh of quinces, lib. i. ; ten sour pome-
granates with their rind ; of astringent wine, one sextarius : boil to
a third, and, having strained, add of honey, lb. vi. ; and, having boiled
to a proper consistence, give for a linctus. It is clear, that the
cataplasms should be made from astringents, the materials of which
you are acquainted with. On account of the tenesmus, which proves
a troublesome symptom in dysentery, injections made from the
juice of rice, chondrus, or the like, with the tallow of goats, and
likewise those recommended in the Chapter on Tenesmus will prove
serviceable. But, if there is a discharge of blood, we must inject
the juice of knot-grass, or of plantain, with acacia, hypocistis, or
the like. But, if this symptom be urgent, we may inject some styp-
tic, such as the ashes of unwashed wool, or of new sponge which
has been soaked in liquid pitch, or the blood of an ox, or liquid
alum ; or, it may be soaked in the juice of asses* dung in like man-
ner, and burnt. And the trochisk of Andron is an excellent reme-
dy, and that of Musa, and the like. But suppositories of collyria
are among the most effectual remedies, more particularly when the
discharges are attended with pain. When there is a spreading ulcer
in the intestines, which you may ascertain from the fetid smell and
putridity of the discharges, and from its not having occurred at the
commencement, but after some interval, we must use escharotic
injections, such as the trochisks called Faustiani, that from paper,
the Bithynian, the Thronian, and that from cork, injected in the
decoction of dried lentils, or of some of the other astringents. And
the following enema is of approved efficacy : — Of burnt omphacis
(it is the cavity from which grows the acorn which the tanners use),
of arsenic, of comfrey, of Syriac sumach, equal parts. Mix about
two spoonfuls of these when pounded together with the juice of rice,
and the juice of alkanet that has the thorny, broad, and black leaf
(which they call chcerospelethronj , and with the white of eggs, to the
amount of two or three ounces ; and give for an injection. Those
Epithemes apply which were mentioned for coeliac aflfection. And,
in like manner, those liniments to the belly which are composed of
astringent and desiccative materials, with some of the glutinous
substances, gum, frankincense, taurocolla, fine flour, may have place
with the corresponding cataplasms. The food at first should be eggs
mixed with milk, and the spoon-meats made from frumentaceous sub-
stances, either alone or boiled with milk. And milk itself moderately
boiled is an excellent thing. The use of pot herbs is not necessary ;
however, we may allow the patients to taste of boiled endive, of
succory, of plantain, of cabbage twice boiled, and of the autumnal
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BOOK THIRD. 309
rue has been boiled, with the grease of a goose or hen ; or, of a de-
coction from the roots of wild cucumber, with a dram of myrrh
and some honey and oil ; or, from myrrh, honey, and Sicyonian
oil. And often, when common oil is injected, the vitreous phlegm
is discharged along with it, and instantly removes the pain. If,
owing to the violence of the pain, the injection be retained, we must
apply a suppository of honey, cumin, nitre, and the dried seeds
of rue ; or, of a stalk of cabbage well shaven down and macerated
in salt water ; or, of the ashes of cabbage mixed with honey ; or,
of colocynth triturated with honey, nitre, and cumin. The sup-
positories should be six-fingers breadth in length, so that they
may extend beyond the sphincter muscle. The anus is to be
anointed with the juice of sow-bread, with honey and nitre, or with
centaury along with honey, and nitre. When the pain is con-
tinued, in addition to the afore-mentioned, these injections are to
be used : — Of turpentine rosin, oz. i. ; or, of opoponax, dr. i. ; or,
of galbanum, dr. iv. ; of bitumen, an equal part, with, of nitre,
dr. i. ; and of water, oz. i. ; of oil of rue, oz. v., or more. Em-
brocations are to be applied to the affected parts from the oil of
cumin, of dill, or Sicyonian oil. Cataplasms are to be applied,
composed of the medicine called Trispermum with cumin, bay- ber-
ries, and parsley seed. Epithemes are to be applied, namely, that
from seeds, that from bay-berries, that from melilot, and the
Polyarchian. Let the patients sit in a hip-bath of the decoction of
fenugreek, marshmallows, camomile, mug- wort, dill, bay, and the
like. And they may be made to sit in a hip-bath of warm oil, or in
oil and water. They should take potions containing wormwood
and cumin, in equal parts, or panacea with water, or of castor, of
anise, and of the peppers, dr. i. with oxymel. When the pain does
not remit, we must give them a draught, containing the medicine
from three peppers, or thetheriac ; and have recourse to a sinapism
and dropax during the remissions, and to the natural baths ; but
they must abstain from bathing in drinkable water, unless com-
pelled to have recourse to them by the urgency of the pain ; when,
having previously injected some of the afore-mentioned medicines,
we must direct them to bathe, and be fomented within the heated
walls of the bath, having been previously rubbed with some of the
detergent ointments containing nitre. When the pain is violent,
we must use those things which are moderately soothing, such as
the trochisk of castor, either injected or taken by the mouth, and
such like remedies. But powerful narcotics must be avoided, which
allay the pain indeed for a short time, but render the affection more
protracted by incrassating the offending matter, and occasioning ob-
struction of the pores of the intestine. When the phlegm is at-
tenuated, we must purge them with hiera picra, or such pills as
these : — Of aloes, of euphorbium, of pure granum cnidium, of scam-
mony, equal parts. The dose is two scruples. A heating and
desiccant diet will suit with them. At first, indeed, they should ab-
stain from food, but afterwards take acrid food. Wherefore we
must give them leeks boiled with prepared wine, and parsley, and
3J0 PAULUS iEGINETAr
mursh asj)aragus, raw garlic, more especially if they do not dislike
these things ; and they may drink of the prepared wine, and take
some bread with it. Afterwards we must give them wholesome
and digestible food> avoiding a surfeit and indigestion. If it is a
flatulent spirit which causes the pain, after carminative injections
and draughts, dry-cupping by means of large cupping-instruments,
heated and fixed along the whole abdomen, often effects a cure.
When the intestine is in a state of inflammation, we must bleed from
the arm ; but, if dysuria prevails, we must likewise open the vein
in the ancle, and use the remedies already mentioned, except those
things which are acrid and powerfully cathartic ; and we must
rather use soothing injections, cataplasms, fomentations, placing
the patient in a hip-bath of oil. We may also apply cupping-in-
struments to them, and lay a cerate upon the abdomen, containing,
of wax, oz. V. ; of camomile, oz. ii. ; of rose-oil, oz. ii. ; of the
flour of beans, oz. Ss. ; five yolks of eggs pounded with the juice
of linseed. The diet should be light, and such as that applicable in
fever, until the inflammation be resolved. But, if the pain arise from
acrid and sharp humours, we must administer injections of oil, in
which has been boiled fenugreek or marshmallows, with plain
fresh grease of a goose or hen, or the juice of ptisan with rose-oil,
or the juice of linseed. They must take the antidote called picra from
aloes in a draught, and use baths of sweet waters, and spoon-meats
from chondrus or ptisan, and fishes caught among rocks ; and, in a
word, the whole regimen should be moistening and cooling. The
patient must abstain from all acrid food and medicines, and from
hot fomentations, by means of embrocations and cataplasms, and
from drinking wine, more especially old. When the pain is 8trong>
we may also use narcotics ; for they prove less injurious in this case
than in any of the others, incrassating and moderately cooling the
thin and sharp humours. I am of opinion, that the colic aflfectioQ
which now prevails is occasioned by such humours ; the disease hav>
ing taken its rise in the country of Italy, but raging also in many other
regions of the Roman Empire, like a pestilential contagion, which
ill many cases terminates in epilepsy, but in others in paralysis of
the extremities, while the sensibility of them is preserved, and some-
times both these affections occurring together. And of those who
fell into epilepsy the greater number died; but of the paralytics
the most recovered, as their complaint proved a critical metastasis
of the cause of the disorder. Those, therefore, who were thus af-
fected, a certain physician in Italy cured, in an incredible way, by
putting them boldly upon a refrigerant diet. For he gave them un-
boiled lettuces previously cooled, and succory, in like manner, to
tat until they were more than sated ; and also grapes, apples, fish
which have hard flesh, and, in short, all the Crustacea ; also the
feet of oxen, the bulbi, and the like, namely, things which were not
only cold by their powers, but likewise to the touch. H^ seldom
gave wine, and, when he did, he mixed it with cold water. And he
gave cold water for drink, or cold oxycrate, and prohibited all
warm food and that of the middle kind ; and, contrary to all expec-
BOOK THIRD. 311
tatioD» he cured most people in this way, and even some who had
begun to experience a conversion of the disease into epilepsy or
paralysis.
XLIV.— On Ileus.
Iliac passion, heing a very acute and painful complaint, has a
symptom more grievous even than dangerous; for those who are over-
powered hy the disease die a most piteous death, vomiting up faeces
at last by the mouth. The affection arises from indigestion and ob-
struction, when the corrupted matters are retained, and from dele-
terious medicines, and from a falling down of the bowels into the
scrotum, and from inflammation of the intestines, commonly super-
vening upon a colic affection. Wherefore children are to be cured
by embrocations, cataplasms, clysters, suppositories, and fomenta-
tions, as described when treating of colic. But young persons and
adults are to be bled without delay, and the operation repeated ; and
dry-cupping is to be freely applied along the abdomen, and cupping
even with scarifications to the affected parts. The extremities are
to be rubbed and ligatures applied round them ; and we must have
recourse to the most drastic clysters and enemata, putting the pa-
tients into hip-baths of hot oil, giving antidotes, and purgatives ;
and simply all things, in short, which are applicable for colics, ex-
cept when the affection of the colon proceeds from acrid and pun-
gent humours. It has a wonderful effect in this complaint to drink
the decoction of dill, even if it should be vomited up ; but, after
drinking it, dip bread in warm water, and give the hot pieces of it
to eat. For those who cannot retain their food, triturate sumach
and cumin in the same, and give to drink in oxymel to the amount
of six cupfuls. Those who are attacked with Ileus from taking de-
leterious substances are to be compelled to vomit by drinking
warm water (the symptoms arising from taking any of the delete-
rious substances are detailed in the Fifth Book) ; and then they are
to be made to drink warm oil, or fat soups, that they may again vomit ;
but, after a certain number of days, they must drink the theriac.
If tJie constipation continue, the belly is to be evacuated by divided
milk (schistonj, with a little scammony, aloes, or some other pur-
gative. If the complaint arise from the falling down of the intes-
tine into the scrotum, we must put the patient into a reclining
position with his feet elevated, and then we are to press the pro-
lapsed intestine up to the groin, and retain it with a bandage.
XLiV. — On Affections of the Kidneys and Bladder ; and, fir sty
on Calculus.
Thb alliance of these diseases obliges us to break through the
order of instruction ; for it is a common symptom of Colic and of
Calculus in the Kidney, that the belly is at first constipated with
312 PAUL.US JLGINETA.
violeut pain, anorexia, indigestion, and tormina. But it is peculiar
to colic affections to have all these symptoms more intense, whereas
in nephritic they are less so ; and in colics the pain is rather in the
right loin, and ascends to the stomach, liver, and spleen ; and the
passage of the faeces is completely obstructed, so that not even flatus
can pass ; or, when with difficulty the faeces are evacuated, they are
flatulent, and resemble the dung of oxen, or sometimes a vitreous
phlegm is discharged, and the urine is voided freely, and is of a
pituitous nature : whereas, in nephritic cases, there is a severe fixed
pain in the kidneys, as if transfixed with a sharp-pointed instru-
ment, and the corresponding testicle is pained,^ and there is torpor
in the thigh of the same side. They also have sometimes, though
rarely, spontaneous evacuations of the belly ; but clysters always
bring away flatus and bilious faeces ; the urine is in small quantity
and sandy ; and the urinary passage is contracted. These are the
symptoms of stones in the kidneys, which occur most frequently
in adults ; but the stones in the bladder form rather in boys. The
symptoms of these are-, unconcocted and whitish urine, with a sandy
sediment; the patients rub constantly and handle the member,
stretch it, and make incessant attempts to pass water, and are
troubled with strangury. Wherefore the material cause of the
formation of stones is a thick and terrene humour, but the efficient
is a fiery heat of the kidneys or bladder. But, with regard to the
kidneys, we must use lithontriptics of a cutting nature, without
being decidedly heating : such are the roots of the royal asparagus
and of the bramble, burnt glass, the root of couch-grass, maiden-
hair, bdellium, the rind of the root of the bay, the seeds of marsh-
mallows, the black chick-pea, the stones of sponges, vinegar of
squills, and valerian, spignel, asarabacca, carpesia,. saxifrage,
water-parsnip, when eaten or drank, the root of golden-^ thistle
(scolymusji hedge- mustard, and prionitis. Let them use baths con-
stantly ; and after the bath take some of the afore-mentioned
things ; and have recourse to embrocations, cataplasms, fomenta-
tions, hip-baths of a soothing nature ; in short, applying the re-
medies for colics. The following are compound draughts : — Boil
the roots of wild rue, wild mallows, and parsley, with wine ; mix
the expressed juice with water; and give to the amount of two
cyathi. And this is a powder : — Of the fruit of balsam, of the
stone in sponges, of dried penny-royal, of the seeds of wildmallows»
equal parts. Give a spoonful with two cupfuls of diluted wine.
Also, dried goat's blood, dried cicadae without the wings and feet,
the Jew's-stone, in oxymel. Let these things be given in the warm
bath, and the compound medicines prepared from them, the ne-
phritic sour wine (poscaj, and the wines prepared for this intention.
And the troglodytes is a much-commended remedy. It is of all
sparrows the least, except that called the royal ; for it is a little
larger than this one alone, and resembles it in colour, which is in-
termediate between that of ashes and green. It has a slender bill,
and lives mostly in walls and hedges. When, therefore, this bird
is pickled whole, and frequently eaten in a raw state, it makes the
BOOK THIRD. 313
stones which are already formed be passed with the urine, and pre-
vents others from being formed. And, if it be burnt alive entire
with its wings ; and, if the ashes by itself and along with pepper and
a moderate quantity of Indian Leaf, be drank out of mulse, it will
ido the same thing. To relieve the acuteness of the pains and the
want of sleep, the medicine called Sotira, and that of Philo, are ex-
cellent remedies. And frequent venesection, if had recourse to,
alleviates the pain, and produces a speedy discharge of the stone.
The preservatives from the formation of stones are, first, whole-
some and moderate food, exercise, abstinence from the frequent use
of all kinds of pulse and frumentaceous food, cheese, milk, and
condiments prepared from dark-coloured wine, much flesh, and
simply all things which contain thick juices ; also, from those
things which are very hot and acrid, I mean, hydrogarum, pre-
pared wines, and the like. And these things not only prevent
stones from forming, but also break down, or produce the discharge
of those which are already formed. Let them drink oxymel with
some of the simpler diuretics, the decoction of maiden-hair, parsley,
and couch-grass. And, after the bath, let them drink tepid water
before taking food or drinking wine. And, in the midst of dinner,
let them drink cold water if nothing prevent. If they feel a collec-
tion of vitiated humours, let them evacuate by bleeding or purging.
But the most effectual of all remedies is, to drink water of a proper
temperature after the bath, and before taking food or wine. The
stones which form in the bladders of young persons you may de-
stroy by the more powerful remedies, making choice from among
the above-mentioned. But, when the stone gets too large, or be-
comes impacted at the neck of the bladder, we must have recourse
to concussion, catheterism, or even lithotomy, as will be described
in the Surgical part of the Work.
On Inflammation. — If there be inflammation of the kidneys or
bladder, it is to be recognised by the heat in the place, attended
with heaviness and pain, fever, delirium, vomiting of pure bile, and
inability to make water, more especially if the bladder is inflamed.
Wherefore we must have recourse immediately to venesection, and
use soothing fomentations and cataplasms from rue, dill, fenugpreek,
and the root of marshmallows ; also emollient clysters and injections
consisting of oil, poppies, and the grease of geese : and, when the
bladder is aflected, we may push up the anus half an obolus of
opium with myrrh, saffron, and oil. They may take a sweet draught
of honied-water, but must abstain from the strong diuretics and
much drink, unless an acrid and bilious humour prevail ; when they
must take copious draughts, and plenty of the non-stimulant diu-
retics. I^et them take in water a spoonful of a mixture consisting
of two parts of linseed, and one of starch ; and, likewise, let them
take the seeds of cucumber and pompion. If there is a sensation of
great heat about the kidneys, apply to these parts rag^ out of wine
and rose-oil, water and rose-oil, or oil of apples ; or a cerate com-
posed of wax, rose-oil, oil of camomile; or oil of apples, and the
yolks of eggs, with a little vinegar, or the juice of knot-grass.
314 PAULUS ^GINETA.
Afterwards they may use the Diachylon plaster with oil of camo-
mile ; but must abstain from very hot applications, lest they occa-
sion suppuration; and from very cold, for thereby the kidneys will
readily become scirrhous. During the violence of the inflammation,
they must abstain from baths, and use the regimen called the febrile
and anti-inflaramatorv.
On Abscess and Ulceration of the Urinary Organs. — Pains
in the loins, anomalous rigors, and irregular fevers, indicate an
Aposteme of the kidneys ; but, whep it is in the bladder, it is marked
by pain in that part in addition to the symptoms we have now men-
tioned. You may ascertain which kidney is affected from this, that,
when the person lies upon the sound side, he has pain in the oppo-
site one, from the diseased kidney being suspended. In these cases,
we must place the patients in hip-baths of oil and water, apply ca-
taplasms of fine flour, oil, and rosin, or the flour of tares with honey,
or cardamom, or pigeon's dung with dried figs. Pus freely dis-
charged in the urine indicates a rupture of the abscess and ulcera-
tion in the part. But, since the urinary organs are ulcerated with-
out an aposteme, from the rupture of a vessel, erosion by acrid mat-
ter, or the irritation of a stone ; we may distinguish ulceration in
the kidneys from that in the bladder or urethra in this way. When
the kidneys are ulcerated, the patient experiences a heavy pain im
the loins, he makes water freely, and pus is found mixed with the
urine, and particles of fle^h floating in it. When the bladder is in
a state of ulceration, the patient has violent pain in the region of
the pubes and hypogastrium, and difficulty of making water; the
pus, after the urine is voided, sinks to the bottom, and fetid scales,
or else foliaceous ones float in it. Furfuraceous sediments indicate
scabies of the bladder. When the ureters are ulcerated, the mix-
ture of the pus is in an intermediate degree, and rather resembles
hairs floating in the urine ; and the situation of the pain is interme-
diate between the kidneys and bladder. If blood or pus be dis-
charged without any evacuation of urine, it is to be understood*
that none of the afore -mentioned parts are ulcerated, but the mem-
ber itself. Wherefore to those who have ulceration of the urinary
organs we must give the sweet draughts of honied-water, or of the
decoction of fenugreek with honey, or from the seeds of cucumber
with must. To those who void pus in their urine we are to give
Armenian Bole, or the ashes of burnt reeds, as much as can be taken
up with three fingers, in must ; and drinking milk is an excellent
remedy for them. The following are compound remedies : — Of
linseed, of the seed of cucumber, of tragacanth, of each, dr. ii. ;
form trochisks. Another : — Twenty pine-kernels ; xl. seeds of the
garden cucumber ; of starch, dr. i. ; add to two heminse of the de-
coction of nard and parsley seed. But Archigenes, in his epistle to
Atticus, says that, " when the Dysuria is urgent, we should take
of the powdered seed of toasted poppy, dr. i., which is to be sprink-
led upon the decoction of bog-rush, eweet-rush, or liquorice. This
medicine removes the pains from ulceration : — Of the seeds of pu^
rifled cucumber, xxx. in number ; pine-kernels, xii. . in number s
BOOK THIRD. 315
bitter almonds whitened, xxxv. in number ; of saffron, what is suf-
ficient to give it colour ; give to the patient with an empty stomach
every day, along with the wine protropum, or milk. It will be
milder, if, instead of the pine-kernels, it receive an equal quantity of
the seeds of mallows. The Cyphi and the Cyphoid antidotes are
also said to cure ulcerations in the bladder. I, in the more pro-
tracted cases, by using this medicine, have not stood in need of more
complex remedies : — Of wall-germander, of ground pine, of each*
dr. xxiv. ; of asarabacca, of whitg pepper, of each, dr. vii. ; of cin-
namon, dr. i. Of this medicine, finely powdered, I give two spoon-
fuls in Cretan sweet wine ; but, if there is fever, in three cyathi of
water ; but, when the ulceration is attended with pain, by adding
two cyathi of starch, and fifteen seeds of cucumber, I accomplish
my purpose." These things are from the works of Archigenes.
And the remedies formed from alkekengi, the antidote from the
seed of wild mallows, and that from sweet-meats are excellent. We
may apply to the perinaeum and lower belly cerates made from
washed hyssop and butter, and the grease of geese, and storax.
And we may inject into the bladder, by means of a small syringe,
honied- water much diluted, or milk with some honey, or with cu-
cumber seed, or the white of an egg with Pomphylyx, or some of
the remedies formerly mentioned. When the ulcer is spreading*
the trochisk from paper must be injected, or the Bithynian ; and
cataplasms are to be applied, made from dates, dried grapes, with
galls, accacia, hypocistis, and alum.
On Hemorrhage of thb Kidneys. — ^The Kidneys, after getting
into a relaxed state, cannot retain the urine, but, becoming dilated,
they allow the blood and other thick matters to escape from the
veins. The kidneys often discharge blood periodically like hemorr-
hoids ; and when evacuated they are relieved, in which cases we
must not rashly interfere, if the bleeding immediately stops ; but, if
it continue, we must bleed in the arm, and use for haemorrhage of
the kidneys and bladder those remedies which are recommended for
haemoptysis and other haemorrhages ; and, more especially, we must
give the root of comfrey and tragacanth macerated in wine, the
juice of knot-grass, and plantain with oxycrate, or bitter almonds
with must ; or this medicine : — Of fissile alum, dr. i. ; of tragacanth,
dr. ii. ; of gum, oboli v. ; with must. And we must apply a cata-
plasm of raw barley-meal with oxycrate or rose-oil, or that from
dates, and bread of siligo with acacia, or hypocistis boiled in an as-
tringent wine or oxycrate. In haemorrhages from the bladder, we
itiast apply cupping- instruments to the loins and ischium ; and we
must ascertain the part from which the blood flows by the pain in
the place, and whether the blood be mixed with the urine or no, a&
\vas said with regard to pus. If there be coagulated blood in the
bladder (which you may know from the flow of urine being suddenly
stopped after a discharge of bloody urine, and from certain clots or
bloody fluids being probably passed), give the decoction of mug wort
to drink, and the seed of shrubby-everlasting, of flea-bane, or of ra-
ffish, or the juice of laser- wort, or the cyrenaic juice, or the juice of
316 PAULUS iEGINETA.
parsley, each mixed with vinegar, or the rennet of a hare, or of a
hind, or of a kid, in oxymel, or strained lye with oil, and externally
sponges oat of hot salt water, or strained lye, mast be applied. But,
if they are not dissolved, we must make an incision in the perinaeum,
as in the cases of calculus ; and, having removed the clots of blood,
accomplish the cure in a proper manner.
On Hardness op the Kidneys. — When hardness occurs in the
Kidneys, it does not occasion pains, but they seem to hang from the
loins, and the haunches are torpid, and the limbs lose their strength,
little urine is passed, and the whole habit resembles that of dropsi-
cal persons. Wherefore they are to be softened by cerates, emollient
ointments, friction and fomentations ; and we must administer diu-
retics, and clear out the bowels by clysters.
On Diabetes. — Diabetes is a rapid passage of the drink out of
the body, liquids being voided by urine as they were drank ; and
hence it is attended with immoderate thirst ; and therefore the af-
fection has been called Dipsacus, being occasioned by a weakness of
the Retentive faculty of the Kidneys, while the Attractive is in-
creased in strength, and deprives the whole body of its moisture by
its immoderate heat. Wherefore with this intention we will give
more food, and that of difficult digestion and not humid, such as
alica with rose- wine, or rhodomel, or hydromel, or some wine that
is not old, or some of the hot wines. We must give of pot-herbs,
succory, endive, and lettuces ; of fishes, those taken among rocks ;
the feet and womb of swine ; pears, apples, and pomegranates ; and
give cold water to drink. They must get to drink Propomata, from
the juice of knot-grass, and elicampane, in dark-coloured wine, and
from the decoction of dates and myrtles. We must apply a cata*
plasm to the hypochondrium and kidneys of polenta, in vinegar and
rose-oil ; and of the leaves of the vine and wall penny- wort,^ pel-
litory of the wall, and purslain. We must promote sweats, and
excite vomiting by drinking cold water; and make them abstain
from all diuretics. There will be nothing improper in letting blood
at the commencement.
On Strangury and Dyscjria. — When neither inflammation,
nor a stone, nor any of the afore- mentioned complaints are present,
if there is acrimony in the urine, and if the whole habit or the
other symptoms indicate bile, the Dysuria or Strangury is formed
by it, and we are to use medicines for altering and diluting it, —
the juice of ptisan, fishes, baths, and a corresponding diet ; avoid-
ing acrid things, wine, baths, anger, and long abstinence from
food. If the tenuity and whiteness of the urine, and the other
symptoms, indicate a cold intemperament, hot wine and prepared
wines will be proper ; also diuretic food and medicines, and hot
hip-baths. When, in conjunction with the whiteness, the urine
appears thicker than natural, we are to suspect a pituitous humour
obstructing the neck of the bladder, and must use oxymel, and the
compositions from hyssop and penny-royal, or marjoram, or thyme,
or laser- wort, boiled in honied -water, and the hotter embrocations.
But, if a thick humour, a stone, a thrombus, or some such ob-
BOOK THIRD. 317
struction stop up the passage of the urine, we must apply the ca«
theter to them, unless inflammation of the part he present. Dysuria
in fevers is to be cured by an embrocation with oil of rue, of dill, or
old oil. When the belly is constipated, a decoction of fenugreek or
mallows is to be injected, and the patient made to sit in oil and
water, or in some of the afore-mentioned decoctions, with oil. And
this cerate will be proper for them : — The roots of wild mallows are
to be boiled in Sicyonian oil, with a little water, until they are dried,
and they are to be thrown away ; and with the oil is to be mixed
of the juice of rue a fourth part, and of wax and castor what is
sufficient.
On Paralysis of thb Bladder. — This complaint, which is
sometimes accompanied with dysuria, and sometimes with an invo-
luntary discharge of water, has been formerly treated of under the
head of Paralysis.
On Incontinence of Urinb. — Relaxation of the muscle at the
neck of the bladder occasions this affection, and therefore it hap*
pens most frequently to children. Our general treatment ought to
consist especisdly of tonics, such as hot wine and oil, and the like,
abstaining from all things which are powerfully refrigerant, and
rather as much as possible using calefacients ; for cold produces a
resemblance to paralysis. The following things are naturally effi-
cacious : — Burn the crop of a cock, and give to the patient to drink
m tepid water, when fasting, or the flowers of the white ox-eye
(chrysanthemum) in like manner ; or, shave down the testicle of a
hare into fragrant wine, and give to drink ; or, give oalamint and
myrrh in a draught before supper ; or, give the toasted seed of the
wild rue to drink every third day. Let the privy member be anoint-
ed with Cimolian earth, mixed with the juice of perdicias (polygo"^
num maritimum ?J.
XL VI. — On the Affections of the Liver,
Thk affections of the Liver being various (for it is subject to
atony, inflammation, erysipelas, scirrhus, apostemes, ulcers, and
obstructions), we shall treat first of atony of it, in which case those
affected with it are properly called Hepatics. If, thwefore, it eva-
cuate the excrements in a state of chyle, but more liquid than na-
tural, the distribution of the food to the liver being either dimi-
nished or altogether stopt, while the stomach is unaffected, it is to
be inferred that the Attractive power of the liver is in a weak state.
But, if they resemble the washings of newly-killed flesh, it is the
Alterative, and, as it has been called, the Sanguificative power that
is affected. But, if the atony arise from a hot intemperament, in
process of time it appears more feculent and very fetid, the bile
being high-coloured and thick. Wherefore, the substance of the
liver being already melted, the whole body also is melted down ;
and there is fever, anorexia, and vomiting of bile. When the in-
temperament is cold, the discharges are neither constant nor many.
318 PAULUS iEGlNETA.
for the affection is a Chronic one ; and for several days the helly
will discharge more abundantly, but less fetid, like the lees of thick
blood, approaching to black bile. And many and various colours in-
dicate a cold intemperament ; for the fever is obscure, the face not
emaciated, and there is rather a desire of food. Whichever of these
intemperaments prevails, if complicated with the dry, the excre-
ments appear drier and fewer in number, and there is more thirst ;
but, if the humid, they are more liquid and abundant, and the pa-
tients have less thirst. When the liver is inflamed, there is, in all
cases, pain in the right h3rpochondrium, extending upwards as far
as the clavicle, but downwards as far as the false ribs ; an acute
fever, dry cough, thirst, loathing of food, and difficulty of breath-
ing ; the tongue at first appears red, but afterwards black ; there is
vomiting of bile, and the belly is constipated. These symptoms
being like to those of pleurisy, we have stated the diflerence under
the head of Pleurisy. When erysipelas is seated in the liver, the
inflammatory heat is intense, there is ardent fever, and marasmus
supervenes. In pjirticular, when the concave parts of the liver are
inflamed, there is nausea and vomitings, anorexia, intense inflam-
matory heat, deliquium animi ; and the parts often become con-
gealed, so that dropsical effusions derive their origin from hence.
When the convex parts are inflamed, the other symptoms just now
enumerated are present, with a visible swelling along its circum-
ference, which is manifest both to the sight and the touch. These
are the symptoms of a strong and great inflammation ; but, if it is
weak, we must order the patient to take in a large inspiration, and,
if he says that he has pain in the right hypochondrium, we may
conclude that there is moderate inflammation of the liver. But, if
an. oblong tumour of a phlegmonous nature appear in the position
of the muscles which lie over it, and none of the aforesaid symp"
toms are present, we know that the muscles themselves are in-
flamed. Weight with distension, and a sensation of pain in the
right h)^ochondrium, without swelling or fever, indicate an ob-
struction of the veins, at the place where those of the porta and
concave parts of the liver join those of its convex parts. When
the inflammation is converted into an abscess, the pain and disten-
sion increase, inordinate rigors come on, and they cannot lie on
the left side without increasing the pain in the liver. When the
abscess bursts, the matter is discharged freely by the urine or belly.
If the swelling pass into a scirrhous state, the pain is diminished,
but there is a manifest swelling, attended with hardness, and the
surrounding parts become emaciated. But, in process of time, the
diagnosis becomes difficult ; for dropsy supervenes, and the whole
hypochondrium is concealed by the water. For a hot intempera-
ment of the liver, we must use those things which have the pro-
perties of moderately cooling and strengthening the viscus, such as
endive and succory, sometimes eaten raw and sometimes boiled with,
coriander ; and the decoction and juice of them may be drunk ; and.
not only thus, but, when sprinkled dry upon honied-water, they re-
lieve hot and cold intemperaments of the liver. And the species
BOOK THIRD. 319
of these herbs called intybus, and troximus, and the sow-thistle, are
possessed of similar properties. And a cupful of the juice of citroA
added to honied water has the same effect, and that of the brake in
like manner. But, if the intemperament is moderate and compli-
cated with obstruction^ these things may be given in some light
wine, or some of the diuretics. And the following pill may be
taken : — Of succory, dr. iv. ; of the root of ground-pine, dr. iv. ;
add to boiled honey, and give to the size of a Pontic nut, and let
the patient take some warm water ; and then be made to drink the
propomata from opium and the seed of hyoscyamus, and the antidote
of Philo. In those cases in which the heat is intense, it may be very
proper to give of the oil of roses, or of apples, in a draught. For food^
let them take of the juice of ptisan, or chondrus, with hydrorosa-
tnm, and bread in like manner out of water, with some of the sweet
potions ; and, in a word, let them take such food as is moderately
cooling without being obstruent. And let them abstain altogether
from wine, unless they require it for some other cause, such as
atony of the stomach ; and, in that case, the kind which is given
should be thin, weak, and watery. And erysipelas of the liver must
be cmred in like manner. When the intemperament is cold, we
must proceed on the opposite mode ; we must give them bread with
wine, and cabbage which has been twice or three times boiled. Let
them taste lightly of chesnuts, take what is sufficient of grapes, and
the flesh of fowls, and drink wine. Let them take a propoma from
eupatorium, asarabacca, or the medicine from pepper ; and a selec-
tion must be made for them from among the remedies formerly
mentioned for Colic and Dysentery. The medicines called c)rphoid
do not suit entirely with the hot intemperaments, unless the heat be
small and joined to much humidity ; but they are excellent reme-
dies for the cold, and more especially if complicated with humidity
or obstruction of the liver. When the obstruction is occasioned by
thick and viscid humours, we may give the myacantha, more espe-
cially the fruit of it, and the rind of the root of bay, agrimony in
oxymel, or in the decoction of bitter lupines, with rue and pepper.
And the flour of lupines in a draught ; and of the roots of cappers,
p. ii. ; of costus, p. i. with wine ; and the medicine from cacanus,
are of use for obstructions occasioned by thick and viscid hu-
mours ; also the iris, the fruit and rind of pistaches, horehound,
and bitter almonds, and the trochisk from them, the root of dra-
cunculus, and wake-robin, agaric, vinegar of squills, and oxymel.
And the dried liver of a wolf, powdered and given with sweet wine
to the amount of a spoonful, is applicable for all the affections of the
liver. And the antidote Theodoretus is one of the best remedies
for obstructions of the liver, scirrhus, chronic inflammation, co-
lics, and jaundice; and in like manner the picra with oxymel.
The food which is given should be of a heating and deobstruent
nature, such as leeks in oxyme], marsh asparagus, and cappers in
like manner ; and the other articles of food should be boiled with
some of the calefacient and deobstruent condiments. They should
drink light old wine, avoiding such as are thicker, and also fre-
d20 PAULUS iBOINBTA.
qaent baths, more especially after food. If the auction be pro-
tracted, we may have recourse to venesection and porging, if
nothing prevent. When the liver is inflamed, we must bleed fix)m
the right arm without delay, and take away a great quantity, if the
strength permit. And over the viscus we must apply externally a
cataplasm made of the flour of barley, of fenugreek, and of linseed,
with dates, or quinces and the flower of melilot, wormwood, and oil
of camomile ; in a word, we must mix astringents with emollients.
The epithemes to be applied are, that of Nileus, the fragrant one,
the Fhilagrianum, that of Apollophanes, that made of meliiots, and
the one called Copton. For great inflammations, the following one
is of tried efficacy : — Of the flowers of wormwood, of Celtic nard,
of asarabacca, of saflron, of each, oz. i. ; of iris, of myrrh, of
storax, of bdellium, of ammoniac perfume, of each, oz. ii. ; of a calfs
marrow, oz. iv. ; of cerate of lentisk, lb. iv. Oxymel is also to be
given to them, and the simple remedies, such as asarabacca, Celtic
or Indian nard, bog-rush, and Macedonian parsley. We must
stimulate the belly by nettle, or the herb mercury eaten boiled ;
and, during the decline of the complaint, we must give of dodder of
thyme (epithymum), and of polypody in honied water; and evacu-
ate the belly with a clyster, in the beginning by means of honied
water with salts or nitre, but in the decline mix with hyssop,
maijoram, or bastard saflron, or centaury and colocynth. In a
word, the concave parts of the liver are to be purged by the belly,
and the convex by the urine. For food, give them the juice of ptisan
in which parsley has been boiled. We have already stated the cure
of erysipelatous inflammation. When an aposteme is formed, we
must promote its rupture, by applying a cataplasm of the composi-
tion called Trispermus, with rosin, manna, pitch, the roots of marsh-
mallows, pigeon's dung, and goat*s dung. But let them take
the propoma from the decoction of poley, that of the fumitory
which grows in hedges, reduced to a third part, the decoction of
treacle-mustard or succory, and of the root of wall-germander. When
the rupture takes place, honied- water and the other things men-
tioned for ulcerated kidneys may be given ; and externally the
plaster of Mnasseus, and the other emollients, plasters, and the
Icesian, or that from willows may be applied. When the liver is
in a scirrhous state, there is little hope of recovery, as the aflTection
will pass into dropsy ; and yet it may be attempted by mixing am-
moniac, bdellium, marrow, grease, and things of similar properties,
with emollients. The patients may take draughts of such things as
will act as deobstruents and detergents of the viscus, such as diu-
retics and lithontriptics, along with those just now mentioned for
obstruction of the liver ; and the diet is to be regulated accordingly.
XLVII. — On Cachexia,
Wb are accustomed to call the commencement of dropsical affec-
tions Cachexia. Wherefore we must cure it by bleeding, if no-
UOOK THIRD. 321
thing prevent, at intervals, and performing the abstraction until the
third or fourth day. But, in an especial manner, we must evacuate
those who have faJlen into this affection from retention of the he-
morrhoidal, or menstrual discharge ; as, in those cases which arise
from a copious evacuation, we must abstain from venesection, and
by all means purge with the hiera from colocynth. The diet should
be light and desiccative ; and recourse must be had to natural baths,
namely the aluminous, and more especially the nitrous, and then
the sulphureous; but the other kind of baths may be taken at greater
intervals. Let them be exercised in every way, more especially by
those who are called Jatraliptse. At last, they must be put under a
course of hellebore. They are wonderfully remedied by a propoma
of wormwood, by sinapisms and dropaces. If the affection is con-
verted into dropsy, we must have recourse to the treatment applica-
ble for dropsical cases in the manner about to be explained.
XLVIIL— 0» Dropsy.
When the liver is greatly congealed, either being the primary
affection, as when it has been inflamed, indurated, or otherwise af-
fected, or from sympathy with other parts, the process of sanguifi-
cation ceases, and the affection is called Dropsy. When a great
quantity of air is collected with a small quantity of fluid between
the peritonaeum and intestines, so that the abdomen when struck
sounds like a drum, the dropsy in this case gets the name of Tympa-
nites, being formed by flatulence about the stomach, belly, and colon,
and by chronic fevers. But sometimes from hardness of the perito-
naeum and of the uterus in women, or from scirrhus, on the contrary, a
great collection of fluid with a very small proportion of air is formed
in the same parts, being confined as it were in a bladder, when the
dropsy is named Ascites, and is occasioned by the afore-mentioned
causes ; but, for the most part, it arises from hardness and scirrhus
about the spleen and liver, and from chronic defluxions about the intes-
tines ; whereby it happens that the belly is swelled, while the rest
of the body is melted by not being nourished. Sometimes through-
out the whole body a colder and more pituitdus blood is collected,
either coming from the liver, or deriving its origin from a melting
down of the flesh of the whole body, which is as it were converted into
water, so that the whole body appears white and pituitous like a
corpse, and then the affection is called Leucophlegmatia, Dropsy of the
flesh, or Anasarca, being occasioned by protracted fevers, cachexia
of the stomach, suppression of long-continued hemorrhoidal dis-
charges, the female flux, dyspnoea, inordinate insomnolency, and
similar causes. In treating these complaints, we commence gene-
rally with evacuation ; but in Ascites and Tympanites it is by ad-
ministering hydrogogue medicines; and in Anasarca by blood-let-
ting, more especially when the affection is formed by retention of
the hemorrhoidal or menstrual discharges, unless the patients had
been previously bled for cachexia. And in this case, ns in cachexia,
y
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--^Cve. ev<.c«ftte«
BOOK THIRD. 323
try the effect of a hydragogue wine. The following makes an ex-
cellent one : — Of squills, oz. iii. ; of parsley seed, of the rind of
the root of cappers, of pepper, of each, dr. iv. ; of peeled grana
cnidia, dr. i. ; of the Indian leaf, two balls ; of best wine, xii. he-
mtnss ; of raw honey, dr. xvi. ; beat together, sift, and macerate in
the wine, bat triturate the squill. The dose is three cyathi. After
the evacuation of the water, we must use the theriac. And ox dung
dried and drank to the amount of a spoonful every day is of mighty
use. We must use the most stimulant clysters, unless the belly be
spontaneously very loose, in which case we must rather use things
for drying it up. When women are affected with dropsy, we must use
this pessary : — Of anise, of cardamom, of cumin, of nitre, of birthwort,
of fenugreek, of penny-royal, of the inner-part of figs, equal parts ;
mix together in the oil called Susinum, and apply /»er vaginam. After-
wards we may use the natural baths perseveringly, and the sand-bath,
but we must abstain from the others ; but, if they do ever go into a
bath, let them sprinkle the body with powders from nitre, salts, mus-
tard, lime, and the like. These things even without bathing are useful,
when rubbed into the belly in a dry state, or with oil. In anasarca,
they must exercise the other parts as much as possible, and use dry
firiction in the sun. And a desiccative diet should be taken. Let
diem, therefore, eat pickle, mustard, garlic, wild and dry fowls,
asparagus, pick-tooth fennel, leeks, wild carrot, and the other wild
pot-herbs ; and the theriac salts, or those of lamblichus may be
mixed with condiments ; and old light diuretic wine may be used, or
if it is at hand, the wine prepared with salt water. But the patients
most abstain from much drink of any kind, and from water alto-
gether.
When the dropsy is attended with fever, the patient must ab-
stain from heating and acrid food or remedies ; but we may give
them intermixed with other things in case of urgent necessity. In
tympanites, purgatives and every medicine which wastes the body
must be rejected, and also the more drastic diuretics ; and we must
use both externally and internally such things as can attenuate and
dissipate the flatus ; and dry-cupping may be frequently applied
over the whole belly. When those who have ascites are not bene-
fited by any of the remedies already described, we must have re-
course to Paracentesis, which does not apply to any of the other
varieties of dropsy.
XLIX. — On the Spleen,
Thb use of the Spleen being to attract from the liver the melan-
cholic humour, which is, as it were, the lees of the blood, if its at-
tractive power be weakened, or the passage obstructed by which
this was formerly attracted, the black jaundice is formed, unparified
blood being distributed over the whole body ; and, if there be hea-
viness and distension about the spleen, or if there be also pain,
obstruction is indicated ; but, if there is none of these, weakness of
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BOOK THIRD. 325
larly. And the ashes of the brazier's shop, when applied with raw
barley-meal in oxyrael, is of use; and the juice of centaury, when
applied externally, and when taken in a draught ; and the decoc-
tion of bitter lupines, when drunk with rue and pepper ; and its floiur,
when applied as a poultice ; and the water in which heated iron has
been often extinguished, when given to the amount of three cyathi
to such as have fever ; and to such as are free from fever, to the
amount of one cyathus with wine and vinegar ; or, the root of the wild
dock with squills, to the amount of three oboli ; or, of wall -german-
der, and of wild thyme, an acetabulum ; all these may be given with
oxymel ; or, give two oboli of the juice of the pimpernel having a blue
flower (anagallis carulea ?) with oxycrate ; or vinegar of squills, or
oxymel. These are compound medicines : — Of the root of panacea,
of ammoniac perfume, of the rind of the root of cappers, of fuller's
herb, of the inner part of dried squills, equal parts ; give one dram.
It is also of use in asthmatic and dropsical cases. Another : — Of
the fruit of tamarisk, dr. iv. ; of pepper, dr. iv. ; of spikenard, dr.
ii. ; of ammoniac perfume, dr. ii. ; triturate with vinegar of squills,
and give one dram in oxymel.
For SciRRBUs of the Spleen. — Of sow-bread, dr. xx.; of
bryony, dr. iii. ; of dittany, dr. ii. ; of dried squills, dr. viii. ; of
fuller's herb, dr. vi. ; of the root of cappers, dr. vi. Give a trochisk
to the amount of three oboli in oxvmel. And the trochisk from
heath is also applicable. The food should be attenuant, acrid, and
dry ; little drink should be taken ; but exercise, friction, and si-
napisms should be had recourse to, and sometimes cupping with
scarifications.
L. — On Jaundice.
Jaundice is a diflfusion of bile over the whole bodv, sometimes
of black, as we stated when treating of diseases of the spleen, and
sometimes of yellow. There are many varieties of this complaint,
the causes and diagnosis of which are as follows : — If Jaundice oc-
curring suddenly in a febrile complaint diminish the fever, it is cri-
tical, being occasioned by a metastasis of the matter from the deep-
seated parts, and, therefore, stands in no need of medicines, but is
soon removed by baths and friction. But, if it is attended with
fever and bilious evacuations from the bowels, and if there be a sense
of weight in the right h3rpochpndrium, it indicates a hot inflamma-
tion of the liver, by which the blood, being rendered bilious, is con-
veyed over the whole body. When there is heat in the part with-
out a sense of weight, the affection is occasioned by a hot intempera-
ment alone of the liver. If it is without fever, and the alvine
discharges are white, an affection of the gall bladder, or of its ducts,
is indicated. When there is a sense of heaviness in the right hy-
pochondrium, it indicates that the ducts are obstructed ; but, when
without heaviness, weakness of some of its powers is indicated, either
of the attractive, by which it attracts the bile from the liver, or of the
326 PAULUS i£GINETA.
expulsive, by which it propels the bile to the intestines. For, when
the blood is not purged of bile, it is diffused over the whole body
(as we stated respecting the black jaundice) ; in which case the
urine is voided very much mixed with bile. But jaundice is also
occasioned by a hot intemperament of the solid parts, which convert
into bile whatever is brought to them in place of food, in like man-
ner as in anasarcous complaints a conversion to a pituitous fluid takes
place. This variety of jaundice is recognised by its not occurring
at once but by degrees, none of the afore- mentioned symptoms
being present. Moreover jaundice is occasioned also by drinking
certain deleterious medicines, and by the external application of
poison from some venomous animal. The cure of a hot intempera-
ment of the liver, and of inflammation of it, and of weakness of its
powers, we have treated of under the head of the affections of it ;
and what we said there is to be applied here without alteration,
that we may not be obliged to repeat the same thing. When both
the ducts of the gall-bladder are obstructed, or either of them only,
we must let blood from the right arm. But some, both in this
case and in jaundtoi; from inflammation of the liver, open the vessel
near the middle finger of the right hand. And we must use anti-
inflammatory cataplasms, and purge with hiera. But persons af-
fected with jaundice must take the propomata from a decoction of
parsley, maiden -hair, or dock ; or. of wild thyme, reduced to a third
part ; or, sprinkle wormwood on the potion. Two cyathi of the
juice of radish, drunk with a cyathus of wine, is also of great use ;
also two or three cyathi of succory alone, and with wine. In cases
of jaundice from inflammation of the liver, give a draught of raulse,
or of a decoction of slender birthwort, or of St. John's wort, or of
maiden-hair, or of fuller's herb, or of madder, in like manner ; or,
a dram of the shavings of hartshorn with wine, or the decoction of
carrot boiled in wine to one-third ; or, they may take a dram of
native sulphur in eggs. These things are of great use also in ob-
struction. But viii. scruples of the seed of orache, with Chrysattic,
or any other must, if drunk when in the bath, effect a proper evacu-
ation. But the picra may be properly given in powder, or with
oxymel, and the one called Theodoret ; likewise the trochisk from
bitter almonds. Give also of cinnamon what can be lifted with
three fingers in a cyathus of mulse, or in mixed water; or, of
myrrh, the bulk of a bean, with xx. seeds of pepper, and the same
quantity of cinnamon. Those affected with jaundice, owing to a
warm intemperament of the solid parts, are to be treated with
gentle friction, moderate exercise, unction, and baths, with a
moistening and moderately-cooling diet, the juice of ptisan, intybus,
endive, succory, fish, and light watery wine. The treatment of
those who are affected with jaundice from drinking some deleterious
substance, or from the bite of some venomous animal, will be laid
down in the Fifth Book. When bile is lodged in the vessels of the
face and eyes, inject elaterium to the size of a vetch, with a woman'^
milk, into the nose while in the bath, and then direct the person to
descend immediately into it, but not to immerse his head; and.
BOOK THIRD. n 32/
after the bath, having given him a recruiting diet, again inject the
errhine in the sun. The juices of sow-bread, of horehound, and of
gith, act in like manner. But let him draw into his nostrils, while
seated in the bath, some acrid vinegar, and compress his nostrils
for a short time, and it will produce a wonderful discharge.
LI. — On Prolapsits of the Navel.
Tbb causes and surgical treatment of Protrusion of the Navel
will be treated of in the Surgical part of the Work. But, since
some restore the parts to their natural state by medicines, we must
now mention that method of treatment : Of fissile alum, dr. v. ; of lees
of wine, dr. viii. ; of rose-oil, dr. x. ; of the galls called omphacita,
dr. ii. ; dilute with wine ; make to the thickness of honey ; and wash
with it ; and put in externally a sponge soaked in oxycrate, and
surround it vriik a bandage. Another : — Of the outer skin of bruised
beans, of galls, of pomegranate flowers, equal parts ; boil in water,
and, when dissolved, pound carefully, and wash with it ; and apply
the sponge, as formerly said. Another : — Of the parings of lead, dr.
xvi. ; of hemlock, of manna, of ceruse, of the juice of hypocistis,
of each dr. i. ; dissolve in wine, and use as above-described.
lAl. — How to make the Chin and Pubes continue long free of
Hairs ; on the Preservation of the Genital Organs ; and,
among other things, of Depilatories.
Mix equal parts of Cimolian earth and ceruse with the juice of
henbane, so as to have the thickness of the Bath sordes ; then add
of oil of lentisk, q, s. ; pound, and use. Another : — Pound together
the juices of hemlock, of deadly night-shade, of henbane, and of
the most tender leaves of lupine, and an equal portion of flea- wort,
aud use, having first scrubbed the part and washed. But, for some
days previously, the patient must drink water.
A Depilatory for Removing the Hairs. — Of the slaters which
live about houses and roll themselves into balls, dr. ii. ; of sanda^*
rach, dr. iv. ; of quicklime, dr. viii. ; of old vinegar, one cyathus ;
of the Lixivial ashes of figs, one cyathus ; boil in a pot, and use in
the bath. Another, simple and inodorous : — Of quicklime, one sex-
tarius ; of sandarach, oz. i. ; boil as aforesaid, and use. But the
subject of Depilatories is treated of along with the Diseases of the
Eye.
LIII. — On Bubonocele, Enterocele, and Hydrocele .
Protrusions of the bowels occasioned by rupture of the peri-
tonaeum are of a very difficult nature, but those from relaxation
are of easier cure ; for, happening commonly to children of a humid
328 PAULUS iSGINETA.
temperament, they, for the most part, can be cured without a surgi-
cal operation, by the application of remedies and suitable bandages.
The under-mentioned remedies are to be applied ; but I must men-
tion, in the first place, that these diseases differ in situation only ;
for, when the intestine remains in the groin, it is called Bubonocele,
and, when it falls down into the scrotum, it is named Enterocele.
Wherefore, take of pomegranate rind, dr. x. ; of the galls called
omphacitte, dr. v. j boil in three cyathi of austere wine ; pound, and
apply, having previously reduced the intestine, and bathed the
part with cold water. Loose it in ten days ; the patient remaining
on his couch thirty days, and drinking of the decoction of cypress
with wine ; or, of cypress balls, three oboli, in diluted wine. This
medicine is applicable to children. Another agglutinative applica-
tion : — Of the roots of comfrey, of the juice of horehound, of bitter
almonds, of gum, equal parts. Another : — Of turpentine, oz. i. ss. ;
of wax, of frankincense, of myirh, of isinglass, of snails with their
shells, of each oz. i. ; macerate the ichthyocolla previously in vine-
gar for three days. Another : — Of C3npress balls, i. e. spherical fruit,
oz. i. ; of galls, oz. i. ; of pomegranate rind, oz. ss. ; of taurocoUa,
oz. iii. ; of manna, of frankincense, oz. ss. ; of comfrey, oz. ss. ; of
snails with their shells, oz. i. ; boil the balls and rind in astrin-
gent wine for a considerable time ; triturate ; mix the other ingredi-
ents, and, when they are added, use. Another : — Of aloes, of pome-
granate rind, of frankincense, of the juice of hjrpocistis, of artificers*
glue, of pitch, of bitumen, oz. i. ss ; of sweet wine, q, s. Another
more complex application, which will answer also with adults,
when the disease is not of long standing : — Of chrysocolla, of tauro-
coUa, of sarcocolla, of ichthyocolla, of gagate stone, of blood stone,
of Syrian sumach, of manna, of acacia, of each, oz. i. ss. ; of the
stone pyrites, of native sulphur, of the breathing magnet, of fissile
alum, of manna, of frankincense, of each, oz i. ; of Brutian pitch,
oz. v. ; of snails with their shells, oz. i. ; of the dross of silver, oz.
iv. ; of galls, oz. i, ; of squamae stomomatis (scales of steel?), oz.
i. ; of copper, oz. i. ; of bitumen, oz. vi. ; of myrtle-oil, q, s, ; mix
the dry things with astringent wine, until the preparation is of such
a thickness as not to stain, and then use. If they cannot lie in a
recumbent posture, bind the application firmly with a triangular
bandage of thick materials, and sufficient to retain the intestine.
Let them abstain from flatulent food, much wine, frequent baths,
strong motion, such as running, leaping, loud crying, and the like.
For hydrocele, so as to evacuate the fluid : — Of pepper, c grains ;
of bay-berries, Ixxx. ; of nitre, dr. xx. ; of wax, dr. xl. ; mix with
half a hemiua of oil, and use. Another excellent application : — Of
the flower of Assian stone, dr. vi. ; of grapes deprived of their
stones, dr. ii. ; of Ethiopian cumin, dr. viii. ; of red nitre, dr. viii. ;
having triturated, apply, fomenting with it late and early. Some
also add of sulphur, dr. viii. Another : — Mixing unslacked lime
with Bath sordes, apply with cerate ; and mix some nitre with the
unslacked lime. Another : — Having burnt the root of a cabbage,
add the ashes to old axunge that has been melted, and remove it
BOOK THIRD. 329
every third day. To prevent a collection of water, use the follow-
ing malagma : — Of wax, lb. ii. ss. ; of pitch, oz. iv. ; of ammoniac
perfume, oz. iv. ; of liquid alum, oz. i. ss. The plaster of the white
poplars and the other epispastics are also applicable.
LIV. — On Inflammation of the Testicle and Scrotum^ and of
the other Diseases of these parts.
You may recognise Inflammation of the Scrotum from the pain
being felt at the slightest touch of the hand, and from the heat and
hardness appearing intense ; whereas, when the Testicle is inflamed,
a slight touch does not give pain, which is only felt when the part
is firmly pressed by the fingers, while the redness and hardness ap-
pear less at the surface ; but, upon grasping it firmly, a deep-seated
hardness meets the fingers ; and fever is sometimes present. To
inflammations of the testicles, in particular, venesection is appli-
cable at the ancle ; and to all these, in general, cataplasms and
cerates. The cataplasms may be made of the flour of beans boiled
in diluted wine, with fat dried grapes deprived of their stones ; or,
boil the root of cumin or asphodel, and, having pounded, mix with
an equal part of the flour of dried barleymeal, and apply as a cata-
plasm ; or, linseed in diluted wine ; or, fenugreek in honied-water ;
or, the root of lily in honied- water ; or, the recent lees of wine, with
the flour of barleymeal ; or, groundsel and green coriander, with
dried grapes deprived of their stones. But, if there is much heat,
apply a cataplasm of the leaves of henbane with wheat flour, or that
of chick-peas ; or, of the leaves of sweet-flag, or of unripe gourd.
When the affection is protracted and attended with hardness, boil
the root of wild cucumber in honied- water, and, having triturated
^ith the flour of darnel, apply as a cataplasm. And this is an ex-
cellent remedy : — Of dried grapes deprived of their stones, oz. v. ; of
boiled chick-peas, oz. i. ss. ; of cumin, oz. i. ; of sulphur, oz. ix. ;
of nitre, oz. i. ; of rosin, oz. iii. ss. ; triturate all together with
Tioney, and apply as a cataplasm. The following are convenient
cerates : — Of oil, one cyathus ; of Colophonian rosin, oz. vi. ; of plum-
bago, of cumin, of dried grapes, of the flour of beans, of each, oz.
iv. ; of wax, oz. ii. ; boil the plumbago with the oil to a proper
consistence, then add the wax and rosin, and, taking it off* the fire,
pour it half-cooled upon the pounded figs and the flour. Another : —
Of the oil of dill and of roses, of wax, of pine rosin, of each, oz. v. ;
of cumin, oz. ii. ss. ; of asses' dung, oz. i. ss. ; triturate the cumin
with the asses' dung, and, when the cerate is cooled, mix and levi-
gate ; then, placing in a rag, use, applying above it wool out of oil
from unripe olives ; or, use equal parts of butter and rosin. If from
sweats there be ulcers in the scrotum, sprinkle powdered gall or
alum upon fat and goats' gall, and anoint. For testicles af-
fected with aphthse : — Having first anointed Cimolian earth with
water, allow it to dry, and wash with warm water, then, having
triturated dried myrtle and a small quantity of alsander, apply as
330 PAULUS iEGINETA.
a cataplasm. Excrescenses upon the testicles are cured by the ap-
plication of the Lizivial ashes of the vine mixed with nitre and
water. When there is pruritus of the scrotum, triturate finely
nitre, stavesacre, dried figs, and liquid alum with vinegar and rose-
oil ; and anoint with it in the bath ; but, after the bath, rub in the
white of an egg with honey.
LV. — On Gonorrhcea and Libidinotcs Dreams.
GoNORRH(BA is an involuntary discharge of semen, taking place
frequently without erection of the privy member, owing to weak-
ness of the retentive faculty. In this case, it will be proper to keep
the patient in a state of rest, covering the loins and pubes with com-
presses out of wine, oil of apples, or that of the flowers of the wild
vine; and cataplasms may be afterwards applied made of dates,
apples, flowers of the wild vine, acacia, h3rpocistis, sumach, and
the like. He may also be made to sit in a hip-bath of the decoc-
tions of lentisk, of bramble, and the like, in wine, or even in water ;
and use desiccative food. After a little while, he may take gym-
nastic exercises, by which both the general system and the affected
parts will be restored to strength. Redundance of semen has been
treated of sufficiently in the First Book, under the head of Hygiene ;
and there, too, impotence is treated of. A cool couch is beneficial in
cases of Libidinous dreams ; also, laying on the right or left side ;
all medicines of a cold nature rubbed into the loins, such as corian-
der, hemlock, ceruse, and purslain, all which are to be used with
vinegar.
LVI. — On Satyriasis.
Satyriasis is a palpitation of the genital organ, accompanying
some inflammatory afl^ection of the spermatic vessels, with erection ;
and, if the palpitation do not cease, it is apt to terminate in paralysis
of the spermatic vessels, or in spasms. Those affected with spasms
die speedily, having at last inflation of the belly and cold sweats.
This complaint sometimes, though rarely, affects women. Where-
fore we must open a vein without loss of time, keep the patient
upon a spare diet without wine, and purge the belly, not freely but
gently, every day. The best articles of food are beet, mallows, a
little of the herb mercury, and the soup of the shell-fishes. A^
simple clyster is no bad remedy. Diuretics must be avoided ; an^
medicines of a cold nature are to be applied to the loins, such a^
the juice of night-shade, of purslain, of henbane, or of hemlock. I^^
may be necessary, also, to rub the penis and the perinaeum with som^
soothing and cooling things, such as litharge, Cimoliau earth, an^
ceruse, added to vinegar, water, sweet wine, or rob. To lie in a
supine posture is hurtful. He may drink of the root of water-lily »
iris, and maiden-hair. Rue is beneficial both in Gonorrhoea wad
BOOK THIRD. 331
Satyriasis. Give likewise fruroentaceous food in small quantity,
and do not gratify the thirst. When the affection is protracted,
cupping with scarifications, may be had recourse to ; or, if a ple-
thora be present, we may evacuate by leeches. A cataplasm of
raw barleymeal may also be applied to the belly.
LVII. — On Priapism.
Priapism is a permanent enlargement of the penis, which is
swelled both in length and circularly, there being no venereal ap-
petite attending it. The part is swelled by a flatulent spirit en-
gendered from viscid and gross humours by a moderate heat. It
is clear, therefore, that the part is not to be heated but cooled mo-
derately, with rose-cerate beat up with water, and with the cerate
of camomile applied to the penis and loins. The diet and medi-
cines should be of an attenuant nature, without being manifestly
heating. We must also apply those things which are found, by
experience, to be naturally efficacious. We may, therefore, give
them also to drink of the water-lily and the seed of the chaste tree,
amd mix green rue with their condiments. Yet this must not be
given at the commencement, for it is heating, but after the use of
other attenuants. If we practise evacuation, it must be by vomit-
ing ; for that by the belly often occasions a defluxion to the neigh-
bouring parts. Exercise and Action are to be had recourse to for
dispelling the flatus. In none of the cases which we have been
mentioning does coition answer, unless when we have reason to
suppose that there is a redundance of semen, owing to restraint
frova enjoyment.
LVIII. — On Impotence of the Parts.
Those having this complaint have lost their venereal desires, and
liave become depressed in spirits on^that account. The cause of it
is a paralysis of the parts, or a defect of semen. Those things which
engender semen are treated of under the head of Hygiene in the
First Book ; and there, too, the incentives to venery of a simple
nature are mentioned; and we must now add those which are
stronger. Wherefore we must use in general those applications
called acopa which are recommended for paralysis ; but, in par-
ticular levigate a bunit swift {stellio), and, adding oil to it, anoint
the great toe of the right foot, and then try the venereal act ; and,
when you wish to give over, wash away the ointment from the toe.
And the composition from swifts called Polymigmaton is a very ef-
ficacious application ; or propomata from medicines which rouse to
erection must be taken, such as this : — Of pepper, of pine kernels,
of Macedonian parsley, of the shavings of hartshorn, of turpentine,
equal parts ; mix with honey. Another : — Of raw chick-peas, of
pine komels, of each, oz. ii, ; of rocket, of pepper, of each oz. i. ;
332 PAULUS .fiGIXETA.
mix with honey, and give two drams in wine. And the compound
medicine called satyriaca, and such like, will be applicable. But
we must also attend to the other causes of the complaint, and ap-
ply remedies corresponding to them.
LIX. — On Complaints of the Genital Organs and Antis.
Ulcers on the pudenda and about the anus, when free from in-
flammation, require very desiccative applications, such as that from
burnt paper, dried burnt dill, and burnt gourd. For humid and
recent ulcers, aloes is a good application, when sprinkled on them
dry in a fine powder. But the medicine which gives least pain
and is as efficacious as any other is pompholyx. But, if the ulcers
are more humid, the bark of the pine by itself and blood-stone are
proper ; but, if the ulcers are also deep, manna must be mixed with
them. And, if the ulcer be spreading, we must apply a cataplasm
of dried lentil with pomegranate rind ; and use the plaster called
Coracum from oxymel, the trochisk called Bithynus, and that from
paper. Fissures in the privy parts and ^nus are remedied by
roasted rosin {colophony ?), rubbed with rose-oil, so as to becoQie
of the consistence of bath sordes, and having the yolk of an egg
and opium mixed ; or the ashes of the dried leaves of ivy burnt,
when pounded with rose- oil in a leaden mortar, may be applied.
And the trochisk from wine and oil and that from Phrygian -stone
are excellent applications for fissures and foul ulcers about the
corona glandis, more especially when the prepuce cannot be drawn
back. Another simple application, which also blunts acrimony : —
Of cadmia burnt and washed, oz. ii. ; of the rose leaves stript of
their nails {i. e, the white parts of the leaves), oz. vi. ; sprinkle it
dry, having first wiped the part with wine. The following is an
application for condylomata : — Of chalcitis, of uncleansed wool, of
cerate, of hart's marrow, of bramble leaves, equal parts, with cerate ;
and that from wine and oil in , like manner. But, if a concealed
ulcer is found on the penis within its opening fthe urethraj, which
is discovered from pus or blood being evacuated without urine, it
may be cured by first washing it with honey diluted with much
water, and then with milk, and then mixing with the milk the
collyrium of aster ; or the white trochisk, or that from lotus is to
be put into a leaden mortar, and the parts anointed, by dipping a
feather in it ; and then a small twisted tent of scraped linen may be
anointed with it and applied. A most excellent application is the
one containing of galls, of pompholyx, of starch, and of aloes^
equal parts, triturated with rose- oil and the juice of plantain.
For Pains op the Privy Parts. — Apply equal parts of buttexr
and of rosin, both properly melted ; or, apply equal parts of myrrlm
and of roasted rosin {colophony or fiddlers* rosin ?) triturated witla
the juice of the plantain.
For Swelling op the Penis. — Of tender vine leaves, dr. i. ; of
ceruse, dr. V. ; triturate and apply ; b^the with cold sea- water; en-
BOOK THIRD. 333
join rest ; and apply bandages to the penis. The Lixivial ashes of
vine twigs applied with vinegar cure thymous tumours of the penis,
and do not permit them to increase again ; and so in like man-
ner the ashes of the burnt bark of willows. In general, the
thymus, myrmecia, and acrochordon will be eradicated by strongly
corrosive applications, and become dead when treated with septics.
But, in particular, elaterium when applied with salts is useful, also
unripe figs with vinegar, nitre, and flour, and the juice of the fig
when rubbed in ; the burnt head of an anchovy pickled, verdigris
calcined with native sulphur, the juice of tithymallus {spurge 9)
when rubbed in, the leaves of basil with copperas, or the fruit
of the large sun- flower applied with wine.
For Invl^mmation op the Anus. — Of ceruse, oz. iv. ; of pom«
pholyx, oz. i.; or of soft cadmia, of frankincense, oz. i. ; of the juice
of endive, one hemina ; mix, adding the juice by degrees until it
be all consumed, and then having made a cerate of two ounces of
wax, and one pound of rose-oil, mix ; and, having shaved the part,
soften with this strongly. Inject by an instrument for extricating
pus, and apply a bandage above. It is of use for inflammatory
fissures, and ulcers of the anus attended with heat or pruritus.
Fob Erysipblas about the Anus. — Of diachylon plaster, lb. i. ;
of rose-oil q, s, ; of pure bread, lb. i. ; of saflfron, oz. i. ; of opium,
oz. i. The saffix>n and opium are macerated in must, and the bread
in water ; then, when they are pounded, the diachylon and rose-
oil are put into them and allowed to soften. It is also applicable
to gout attended with the greatest heat. Another, applicable also
to inflammation of the anus : — ^Triturate ceruse with wine and rose-
oil in a leaden mortar with a leaden pestil, anoint with it ; or, hav-
ing triturated ceruse, the white of an egg, and rose-oil in the same
mortar until it become of the consistence of bath sordes, anoint with
it.
Fob Acute pain of the Anus. — Of the tender leaves of hen-
bane, of the tender leaves of purslain, of crumbs of bread soaked in
wine, of the yolks of roasted eggs, equal parts ; of rose-oil, q, s.
After fomenting the part with the decoction of roses and melilots,
apply this cataplasm.
An Excellent Application for Inflammation op the Anus,
AND Excrescences thereof. — Of ceruse, of litharge, of ammoniac
perfume, of bdellium, of each, scr. vi. ; of turpentine, oz. i. ; of
wax, oz. Ss. ; triturate the powders with the juice of night-shade,
of henbane, or of purslain ; and, having mixed the soluble articles,
take, and, having softened them with rose-oil, use. And the com-
position called Phicotyche, and that from plumbago, are excellent
applications for inflammations of the fundiment. And the trochisks
from lotus, from winter-cherry, and that from roses are esteemed
applications for the anus and privy parts.
For Excrescences of the Anus. — When these excrescences
are inflamed, we must use the general applications already men-
tioned, and in particular the following trochisk : — Of ceruse, oz,
iii. ; of pompholyx, oz. i. ; of litharge, oz. ii. ; of mastich, ser.
334 PAULUS iEGINETA.
iii., add to the juice of henbane. When they are free from inflam-
mation, sprinkle the a&hes of burnt Cjrpress balls, having first
washed the parts with wine, or the ashes of the burnt peel of dried
gourd, or of the bones of dates in like manner, or the ashes of egg-
shells and of fennel ; or, having mixed the juice of pomegranate leaves
with an equal portion of white wine, wash with it for seven days.
For callous excrescences : — ^Triturate quick-lime and arsenic with
strong vinegar. It will answer well if you anoint with it in the
sun.
On Hbmorrhotds, or Piles. — ^When piles discharge more than
is proper, the consequence is, that the system h reduced to a
watery state, and they lose their appetite. There is risk both from
the hemorrhage becoming too profuse, and from its being altogether
suppressed ; and, therefore, the treatment is attended with dif*
ficulty. Wherefore, when the piles are numerous, one ought always
to be left for the sake of purging the system. Some also are seated
high up, and do not make their appearance, which renders them
difficult to be cured. Blind piles discharge nothing, but are on
that account more painful than the others. On them, therefore,
rub the juice of sow-bread, which will open them. For immoderate
discharges, take of the Egyptian thorn, of the leaves of the elder,
of mugwort, of each, oz. v. ; boil in eight hemine of water to one-
half, and add of ironwort oz. iv. The herbs are then to be thrown
away, and to the decoction the following things are to be added in
powder : — Of melanteria, of round alum, of each, dr. viii. ; of
litharge, dr. iv. ; of galls, oz. iii. ; of misy, dr. ii. ; of endive, dr.
ii. Dissolve this powder in the decoction, and bathe with it seven
times in the day ; but on the following day bathe with an equal
quantity of another preparation of the same kind, and on the third
in like manner. If any part of them remain on the fourth day,
pierce it with a needle, and, if it has any feeling, or bleeds, prepare
a decoction like the former, but add only one-half of the powder ;
but, when you have washed with it, touch with the powder, that they
may be properly burnt. For the inflammation, apply a bread
poultice. Another : — Having soaked pure bread in primary sauce,
and having burnt it in a new pot, triturate, and apply it, having
first bathed with wine. It is applicable also to excrescences.
Another : — Of endive, dr. ii. ; of chalcitis, dr. i. ; of misy, dr. i. ;
of copperas, dr. iii. ; of fissile alum, dr. ix. ; of burnt copper, dr.
i. ; of melanteria, dr. i. ; use in a powder. The food for those
who have immoderate discharges should be such as forms but
little blood, and is not excrementitious, of a desiccant and astringent
nature, such as chondrus soaked in oxycrate, rice, and halica, and
of pot-herbs, intybus, succory, and purslain, and of wines such as
are astringent. For blind piles, food of an opposite description is
proper, but particularly the fish called calamary, the cuttle-fish,
polypus, the torpedo, and the cartilaginous fishes ; for these
things raise a tumult in the blood. Emmenagogues are also pro-
per remedies in this case.
For Procidentia Ani. — Of the fruit of heath, of gall8> of ceruse,
BOOK THIRD. 335
of acacia, of the j[uice of hypocistis, of pine bark, of frankincense,
of Aminsean m3rrrh, equal parts ; apply in a powder, having first
bathed with austere wine. Another : — Of the dross of lead, of
Syriac sumach, of each, oz. viii. ; of the flowers of roses, dr. iv. ;
of Aminsean myrrh, dr. ii. ; use like the first. Another : — Of pine
bark, of manna, of litharge, of each, dr. viii. ; of dried cypress
balls, of plumbago, of each, dr. ii. ; use as directed above. Bathing
with the patient's own urine while yet warm is also useful.
LX. — On Affections of the Uterus ; andy first, of the Men-
strual Discharge,
With most women the menstrual discharge begins about the
fourteenth year of their age ; a few have it earlier, in their thir-
teenth or twelfth ; and not a few are later than their fourteenth in
having it. There is no limited time for the continuance of it, many
having it only for two or three days, most women for ^ve days,
some for seven, and a very few have it for twelve days. The
menses cease about the fiftieth year of age, a few have them till
sixty, and with some they begin to disappear about thirty-five, par-
ticularly with such as are fat. When, therefore, the evacuation is
delayed, it will be proper to have recourse to baths and potions be-
fore the expected period, such as the fragrant draughts from
sesame, or the headed leek boiled together with pepper and me.
But they must be drunk in Cretan sweet wine. Having drunk a
cotyl^ of it, let the woman excite the flow of the menses by walk-
ing ; and let her eat calamary, cuttle-fish, and polypus, and other
things of the same kind, for they are particularly adapted for raid-
ing a tumult in the blood.
LXI. — On Suppression of the Menses.
Thb menstrual evacuation is sometimes suppressed owing to a
weakness of the whole body, and sometimes owing to a particular
aflection of the uterus itself, from local coldness, or a blow, or
a congenital intemperament, or from some sustained injury, for the
most part from abortions, or from a primary affection of some of
the more important organs, such as the liver, belly, and chest, or
from some such part labouring under a chronic affection. When
suppressed, it becomes the caase of many and protracted complaints.
If, therefore, the discharge be suppressed or delayed, owing to a
primary aflection of any of the internal parts, we must first direct
our particular attention to the cure of the part originally aflected,
and afterwards think of the uterus. The symptoms of these we
have already mentioned. When none of them therefore is present,
it is clear that the uterus is the original seat of the complaint ; and,
when neither the age,habit,noranyother thing prevents, we must have
recourse to venesection, yet not before the regular period of menstru-
336 PAULUS iEGINETA.
ation, but ten days after it is past. The quantity to be taken must
not be more than two pounds and a half, nor less than one ; and,
whether we bleed or not, we must purge with the hieraof colocynth,
giving it to the amount of two drams, in six heminse of honied-
water. But, when fever is present, it is not expedient to purge with
hiera, but it will be advisable to open a vein during the first days
of the fever. After the purging, we must give recruiting things for
a few days, and afterwards recommend exercise by walkmg, friction
of the lower extremities, and the bath. The most proper food will
be that which is of easy digestion and humid, such as all sweet pot-
herbs, and fishes taken from among rocks, the more tender parts of
fowls, milk, honied cakes, thin white wine not very old ; flesh and
pulse, except ptisan, are improper. When the accustomed period is
at hand, give of sea-fish the cartilaginous, and the mollusca, as
they are called, and the testacea, and headed leeks (porrum capu
tatum), boiled with rue and pepper; and let the woman drink the
decoction of them, and apply ligatures to the lower extremities for
three or four days. When the expected period is at hand, the liga-
tures are to be removed, and she is to take before-hand fragrant
draughts of myrrh, to the amount of an obolus, or the size of a
bean ; or, of castor with must, or with honied-water ; or, the
decoction of mugwort ; or, of sage after the bath in must, and in
that of wormwood. The wine of wormwood should be drunk as a
.propoma during the whole time of treatment. When the period
has gone past, and no discharge, or at least none of any conse-
quence has taken place, we must open a vein at the ancle, and ab«
stract blood ; but, after the seventh or eighth day, we must purge
with hiera ; and, after the fourth day, a calefacient plaster (dropax)
is to be applied to the lower part of the belly, loins, and thighs.
Having drunk water for three days, let a cataplasm made of equal
portions of mustard and soaked bread be applied until the equi-
nox, after which let the patient bathe. Next month, let dried figs
instead of bread be mixed with the decoction of fenugreek, of mal-
lows, of penny-royal, of rue, and of mugwort. And let oil of lilies
(susinum) or of marjoram be injected into the vagina ; and let the
pessary called Enneapharmacus, or the Olibanius be introduced. A
pessary consists of carded wool, rounded to the shape of the finger,
and impregnated with the medicines. This mode of treatment is
generally sufficient for restoring the menstrual evacuation ; but
if stronger medicines are required, they are as follow : — lUyrian
iris drunk with wine and cyperus, the root of wake-robin, cassia,
the schenanth, valerian, a decoction of the root of elicampane,
myrrh to the size of a Grecian bean drunk with must in half a hemina
of honied- water, and two heminaj of the decoction of dittany, and
ammoniac, and sagapene. To persons whose stomachs are less
easily deranged, a small quantity of opoponax, made into a little
ball, and steeped in boiled honey, may be given. Moreover, cer-
tain common seeds are calculated to promote the menstrual evacua-
tion, but in an inferior degree, such as fennel, cumin, parsley,
Cretan carrot, hartwort, Bishop's weed, sison, chick-peas, juniper
BOOK THIRD. 337
berries, and all the diuretics. But the folluwing things are to be
applied per vaginam : — Myrrh triturated with the decoction of
wormwood, or of lupines ; or, triturated with the juice of rue ; bdel-
lium, in like manner ; storax, the gum of the wild olive, and that
of the juice of rue, in like manner ; or, the long birth wort made
into the form of a collyrium ; and so also the root of the great cen-
taury ^ or of hellebore, or the juice of scammony, and the medullary
part of the wild gourd by itself, and mugwort formed with rue, and
galbanam applied in the form of a fumigation* These things are cal-
culated also to expel the foetus.
LXII. — On Immoderate Menstruation and Uterine He-
morrhage.
Thb discharges in women become immoderate, sometimes from
retention of the menses which break out more copious than usual,
and sometimes after parturition at the full time, when they cease
spontaneously for the most part ; and frequently after miscarriages,
when a violent hemorrhage often takes place, and proves dangerous.
In the first place, then, we must apply ligatures round the mem-
bers, at the arm-pits and groins ; give to drink oxycrate not cold ;
sprinkle with oxycrate ; and apply to the parts a large quantity of
wool squeezed out of wine and oil, or rose-oil, or oil of apples, or*
myrtle-oil. For food, we may give chondrus soaked in oxycrate,
or rice, or alica ; but, prohibiting wine, we may give austere
hydromel, omphacomel, or the like. The patient may take propo-
mata of pomegranate flowers in oxycrate, or the juice of hypocistis,
or of acacia, or lycium, or Samian earth, or unripe grapes dried,
or rhaharb, or the ashes of cork burnt in an Italian vessel ; or, she
may eat sesame soaked in oxycrate until it become soft. The fol-
lowing substances introduced into the vagina stop hemorrhage : —
The juice of hypocistis, or of acacia, with manna, being triturated
with vinegar. An admirable application is a sponge soaked in
wine or liquid pitch, and applied ; or, the ashes of it burnt when
applied with vinegar or oxycrate ; and, in like manner, the ashes of
cork humt in an Italian vessel. But astringent epitbemes applied
externally are beneficial ; and cataplasms from dates and quinces,
containing also pomegranate rind, or the tops of bramble, or acorns
of the holm oak, or the leaves of lentisk, wild pomegranate flowers,
acacia, hypocistis, gall^, or alum ; but more particularly the follow-
ing : — TaurocoUa is macerated in oxycrate until it is dissolved, and
is then spread upon a strong rag, and glued to the loins. The ag-
glutinative plasters are also powerful remedies, such as the Har-
monium, Icesium, Athena, Melinum, Indicum, and the like. Pes •
saries are to be used for the hemorrhage ; mixing the inner-part of
galls powdered, and rosemary with water, apply : or, the flowers of
the cultivated pomegranate, or the sweet pomegranate in like man-
ner, or powdered knot-grass. The following is a compound one : —
Of fissile alum, of the inner- part of galls, of the juice of acacia, of
z
338 PAULUS iEQINSTA.
manna, of each, dr. iv. ; the yoUcs of four roasted eggs ; these powders
are rubhed with the juice of plantain, and mixed. In using it a
pessary of wool is impregnated with it, dipt into rose-oil, and ap-
plied. And dry-cupping by large instruments applied frequently
under the nipples acts powerfully by revulsion. The following is a
composition for a hip-bath, in which a person having hemorrhage
may sit : — Of the heads of sharp rush, of myrtle, of roses, of the
leaves of rhamnus, of bramble tops, equal parts; boil in water,
which let the patient use for a hip-bath. Another : — Of the bark
of sweet pomegranate root, of myrtle, of the rind of cypress, of each,
p. iii. ; of galls, p. i. ; boil iji a sufficient quantity of water. Inject
with an uterine syringe the decoction of plantain, or of endive, or
of knot-grass, or of night- shade, or of perdiciam, or of flea- wort, or
of hypocistis, or of acacia ; and let these things also be applied
with wool, or by the finger, or a speculum, or a long- shaped feather,
to the mouth of the uterus. And the Trochisk of Andron, when in-
jected by an uterine syringe, with gome of the decoctions formerly
mentioned, or with astringent wine, is an active remedy.
LXIII. — On the Female Flux.
This is a defluxion of the uterus, by which the whole body is
purged. Wherefore that which is evacuated is of the same colour
as the prevailing humour. It is red, when from the ichorous part
of the blood ; white, from phlegm ; pale, from bitter bile ; and black
from black bile ; and sometimes it is watery. If the blood is dis-
charged pure as in venesection, we must attend carefully, lest there
be any erosion of the uterus. The flux is recognised by the follow-
ing symptoms : — The parts are moistened with fluids of various
colours ; the patient is pale ; is not nourished ; and loathes her food ;
and is affected with difficulty of breathing when she walks ; her eyes
are swelled ; and the discharge sometimes is accompanied with pain,
and sometimes without it, with ulceration, or without it ; and the
ulceration is inflammatory, foul, or clean. Wherefore, when the
affection is of a humid nature, we must endeavour to remedy the
general system by administering such things as are desiccants, with-
out being manifestly of a heating nature. The whole body is to be
rubbed, and anointed with honey properly boiled, and we must give
diuretic medicines, such as water in which asarabacca and parsley
have been boiled, and evacuate the whole body by the belly. In
addition to these, purslain when eaten, and the juice of it when
drunk, are beneficial. Also the flowers of the wild pomegranate,
the fruit and flowers of bramble, that part of an oak which is
under the membranous part of the trunk, and that which is be-
low the peel of the acorn. Horse-tail in particular stops a red dis-
charge, when drunk with water, or wine ; or hypocistis ; the fruit of
lentisk sodden with wine and drunk ; Samian aster, Lemnian earth,
the rennet of a hare, or of a kid, or of a lamb, or of a calf, or of a
stag; grape- stones triturated, myrtles, dried unripe grapes, the
BOOK TUIBD. 339
bai^ of the pine, and those things recommended for uterine hemorr-
hage, unless the most dradtic. When the flux is attended with
pain, we must inject with an uterine syringe, or clyster instrument,
the jaioe of alica, or of ptisan, or of tragus, or of rice, with some of
the anodyne medicines. And, during the exacerbations, we must
soothe; but, during the remissions (for it has its periods), we must
try to alter the system by different kinds of gestation, walking, voci-
feration, anointing, cupping, dropaces to the parts above, isolation,
firicticMi, depilatories, detergent ointments, sinapisms, emetics from
radishes, a restorative regimen, baths, wine« and variety of food.
LXIV. — On Ir^mmation of the UierttSj and Change of its
Position.
Inflammation of the uterus takes place from several causes ; for
it may arise from an injury, from retention of the menses, from cold
and inflation, not unfrequently from abortions, and from parturition
after a bad conception. Inflammation of the uterus is accompaniedwith
acute fever ; pain of the head and tendons, of the balls of the eyes,
of the wrists, and of the fingers ; retraction of the neck, and retro-
version ; sympathy of the stomach ; and the mouth of the womb is
shut np ; the pulse small and dense. If the inflammation be weak,
they have not violent pain in the uterus ; but, if it be strong, the
pain is of the pulsatory kind, which, when the whole of the uterus
is aflTected, darts through the whole of it, but, when the inflamma-
tion is confined to a spot, the pain indicates the seat of it. When,
therefore, the posterior parts only are inflamed, the pain is in the
loins, and hardened lumps of faeces are confined by the compression
of the rectum ; but, when the anterior parts are affected, the pain is
seated at the pubes, and there is strangury or dysuria from pressure
on the bladder. When the sides are inflamed, there is tightness of
the groins, and heaviness of the limbs ; but, when the fundus is af-
fected, the pain is principally near the navel, with swelling thereof ;
and when the inflammation is in its mouth, there is pain in the
bypogastrium, and, if a finger be introduced per vaginam, the
mouth of the womb will feel hard and unyielding. As to the treat-
ment, we must, in the first place, use embrocations of wine and oil,
or of wine and rose-oil to the pubes and loins, by means of folds of
dean wool without a bandage ; and abstinence from food is to be
lireserved for three days, after which we are to let blood from the
arm, if nothing contraindicate. The patient is to be supported with
diondrus out of honied- water, bread, or soft eggs, every alternate
day. But, after the fifth day, we are to apply a cataplasm made of
fine flour, linseed, or fenugreek, with honied-water in which the
heads of poppy have been boiled and thrown away, and oil along
with them. £ut, if the inflammation, being of an erysipelatous nature,
do not endure heat, boil melilot in must, and, having pounded, add
the yolks of roasted eggs, with rose-oil, oil of apples,. or of saffron,
and apply as a cataplasm ; or, having boiled dates in diluted wine,
z 2
340 PAULUa JBOINKTA.
pound with fine polenta, and some of the afore*iiientioiied oint-
mentSy and apply as a cataplasm ; and, when the complaint is on
the decline, add the cerate of nard, or of privet. Throoghout the
whole treatment the patient mnst sit in hip-baths prepared from the
decoction of fenugreek, linseed, mallows, mugwort, and oil ; and those
who cannot bear these heating things must use rose-oil dissolved in
hot water. Recourse must be had to pessaries, and injections prepared
from the sordes of unwashed wool, and butter, stag's marrow, the
grease of geese, the ointment called Susinum, and Tuscan wax. When
the patients can endure heating things, the pessary called the Grolden
will suit with them, and the Enneapharmacus ; but, when they can-
not endure heating things, the pessaries are to be prepared from
eggs, rose- oil, the fat of geese, or of domestic fowls. For inflam-
mations attended with a greater degree of heat, melt diachylon
plaster in a double vessel with rose-oil, and add the juice of plan-
tain, or of endive, of succory, or of intybus. Or, use the following :
— Of the fresh fat of geese, or of swine, dr. iv. ; of the cerate of
roses, or of the Susinum, oz. ii. ; of the yolks of roasted eggs, oz. i* ;
of saflron, dr. i. ; of myrrh, three oboH; of opium, two oboli; or,
instead of opium, the decoction of poppy heads. When the pain is
great, give poppy juice (opium) to the size of a lentil, with woman's
milk, or the juice of fenugreek, as an application per vaginam. For
inflammation with hardness, dissolve the ointment called Tetraphar-
macum in rose-oil, and introduce or inject. And, when there is
derangement of the position of the uterus, it is to be treated like
inflammation during the violence of the attack ; but, during the re-
missions or decline, emollients are to be applied ; and, when the
complaint is protracted, alteratives {metaayncritica) are to be used.
But, if there is hardness externally, we must have recourse to
malagmata — that from melilots, that of Mnasaeus, the Icesian, that
from apples invented by Sarapion, and that from wheat. The diet at
first should be light ; but, when the complaint begins to decline,
the patient may use the bath, and take a more varied and generous
diet.
LXV. — On Abscess of the Uterus.
Whrn the inflammation is converted into abscess, all the symp-
toms formerly mentioned become more intense ; and, besides, there
are irregular attacks accompanied with rigor, which at first are
attended with intense pain ; but, when suppuration has fairly taken
place, there is some remission of it. About the time of the abscess
bursting, the pains, however, become more keen, and seem to attack
in a pungent manner ; the fevers formerly slight become more op-
pressive ; sometimes there is obstruction of the urine, and sometimes
of the faeces, occasioned by the pressure of the affected part of the
uterus. Sometimes there is swelling in the region of the pubes,
and a sense as it were of fluctuation, when the abscess is large.
Abscess in the more external parts is discovered by means of the
BOOK THIRD. 341
surgical instrament called dioptra. or the touch of the finger, and
from the pains being more violent, owing to the nervous nature of
the mouth ; as, when the collection is in the fundus and vagina, it
is attended with less pain, and no swelling is felt heavy upon the
finger, and the mouth of the womb appears less tumid. Wherefore
we must promote suppuration by cataplasms of fenugreek, linseed,
barley, or wheaten flour intermixed with boiled figs, and some-
times with pigeon's dung. Let the patient often use the hip-baths
recommended for inflammation, and pessaries of turpentine, myrrh,
oesopum, and butter. When the abscess bursts, if the matter pass
to the bladder, we must give milk to drink, and draughts from the
seeds of cucumber ; but, if it is discharged into the rectum, we must
throw up injections of lentils and pomegranate rind. But, if it burst
into the vagina, provided the pus be pure, we may inject rose- oil,
or whitened oil, or the ointment composed of four ingredients,
which is called basilicon, or fresh butter ; but, if a thin fetid ichor
is discharged, as from a spreading ulcer, we must use an astringent
injection of myrtles, dates, and dried lentils ; and, after the discharge
of the humours, if there be inflammation, we must persevere with
the cataplasms and hip-baths. When the aposteme is seated about
the mouth of the uterus, and does not burst, after the parts which
cover the pus have become thin, we must endeavour to procure the
evacuation of the pus by a surgical operation, as will be explained
in the Surgical part of the Work.
LXVI. — On Ulceration of the Womb.
Tab uterus is often ulcerated from diflicult labour, extraction of
the foetus, or abortion, or injury of the same occasioned by acrid
medicines, or by a defiuxion, or from abscesses which have burst.
If, therefore, the ulceration be superficial, it is detected by the
dioptra, but, if deep-seated, by the discharges ; for the fluid which
is discharged varies in its qualities. When the ulcer is inflamed,
the discharge is small, bloody, or feculent, with intense pain ; but,
vrhen the ulcer is foul, the discharge is in greater quantity and
ichorous, with less pain. When the ulcer is spreading, the discharge
is fetid, black, attended with violent pains, and other symptoms of
inflammation ; irritation is produced by relaxing medicines, and re-
lief by the opposite class. When the ulcer is pure, the fluid is
small in quantity, consistent, without smell, thick, white, with an
easy sensation. When the ulcer is inflamed, we must use those
things recommended for inflammations. When it is foul, we must
inject the juice of ptisan with honey, or basilicon ointment -with the
oil called Susinum ; or honied- water, having fenugreek, mallows,
bran, or lentil without its husk, boiled in it ; and, in order to clean it
the more, horehound or vetches may be added ; or, mixing with
honey the flour of vetches, or iris, or round alum, or the like, we
may inject them. And externally we may apply cataplasms of the
same things mixed with honied-water. And this medicine is par^
342 PAULUS iKOIN£TA.
ticularly applicable : — The finest saffron is triturate4 with a woman's
milk, and, being added to rose-cerate with the grease of a goose, is
Tabbed upon flocks of wool. But the following is a more eflfectual
application, and one proper for violent pains : — Poppy heads are
mixed in diluted must for three days, and then boiled until they be-
come soft ; then dr. v. of rose-leaves, and dr. iv. of safllron are
pounded together, and the decoction of the poppy heads mixed with
them ; then ii. dr. of wax melted with rose-t)il are poured on them,
and applied on a pessary, anointing with rose-oil. The same good
effects may be derived from the preparation of eggs, safl^on, rose-
oil, the grease of a goose, and stag's marrow. And the Egyptian
ointment without the verdigris applies admirably for the cure of
ulceration. When the ulcer is spreading and attended with in-
flammation, we must apply a cataplasm of warm bread mixed with
hydromel, oil, marshmallows, fenugreek, and fatty dates. We must
inject also the juice of plantain, of nightshade, of knotgrass^ and of
endive, first by themselves, but afterwards with austere wine or
vinegar. When the ulcer spreads and is without inflammation, we
may inject more tonic remedies, such as the decoction of pome-
granate rind, of roses, of olive shoots, of cypresses, of quinces, of
bramble, of myrtles, of lentisk, of buck-thorn, of sumach, in astrin-
gent wine, and afterwards with alum, acacia, lycium, and hypo-
cistis. A hip-bath is also to be prepared from these decoctions.
When these things do not succeed, we must use an injection at first
of paper with oxycrate, and then of vinegar, or of the powder
called anthera, or of chalcitis, or of copperas, in the same liquids ;
or of the remedies for dysentery. We must allow wholesome
food in small quantities. When the ulcer has become clean, we
must bathe more frequently, administer food freely, and give wine,
BO that the body may soon recover its flesh. In place of a pessary,
we may inject the preparation from mulberries mixed with cala-
mine, Cretan cistus, or plumbago. Externally we may apply the
epulotic plaster to the abdomen and loins ; for the powers of cata-
plasms, as well as those of plasters, may be communicated by the
insensible pores of the skin.
hXYll.— On Cancer.
Op Cancers in the womb, some are attended with nlceration, and
some without it. In those cases in which the part is not ulcerated,
a tumour is found about the mouth of the womb, hard, unequal,
callous, of a feculent colour, and red, but sometimes also somewhat
livid ; and they have violent pains in the groins and abdomen, the
lower part of the belly, and the loins. They are exasperated by
handling and complicated applications. When the cancer is ul-
cerated, in addition to the pains, hardness, and swelling there are
phagedenic and unequal ulcers to be seen, which for the most part
are foul, callous, white, and having ugly scabs on them ; but some
appear clean, some feculent, or livid, or red, or bloody. The di»-
BOOK THIRD. 343
charge from them always is a thin ichor, watery, hlack, or tawny,
and fetid ; but blood also is sometimes discharged along with the
other symptoms of an inflamed uterus already mentioned. Where-
fore the complaint is incurable, as Hippocrates has pronounced, but
may be alleviated by hip-baths from fenugreek, and mallows, and
by catapla&ms of a like nature. And the exacerbations of the com-
plaint may be much alleviated by common mallows, or marshmal-
lows softened by boiling in honied- water, and pounded with a little
rose-oil, and applied ; and by a cataplasm of dried figs and melilots,
rue, frankincense, and carrot bruised carefully with oil, and also by
that from dates boiled in must, containing also the yolks of eggs,
and fine flour ; or that from poppies with coriander, knot-grass, or
endive. These things are to be applied during the violence of the
pains ; after which a cerate may be applied from rose- oil, or myrtle-
oil, or the oil from the flowers of wild vines, or that of apples with
dates boiled in must. But one particularly recommended is that from
the sediment found in copper vessels, which, being burnt, is reduced
to a powder, and mixed with the cerate of roses until it acquire the
consistence of a plaster. These are the external applications. But
oil applied internally is soothing to the parts. And, when they be-
come ulcerated, the milk of a woman may be injected, and the tepid
juice of plantain. But, if they bleed, the infusion of knot-grass
with a little rosemary proves soothing ; and so also do pessaries
medicated with saflron, women's milk, and the juice of poppies, and
the sordes of unwashed wool. But the following is one of the best
applications, and answers also for aflections of the anus : — Of washed
Italian litharge, oz. vi. ; of male frankincense, of the sordes of un-
washed wool, of fresh axunge, of newly-made butter, of Tuscan wax,
of each, oz. ii. ; of rose-oil, oz. iv. ; triturate the litharge with the
juice of endive, and add to the other things when melted. Food of
easy distribution and wholesome may be given, and some watery
wine ; avoiding acrid food and repletion, for they are apt to be
troubled with indigestion.
LXVIII. — On Scirrhus and Scleroma.
The uterus becomes scirrhous, sometimes suddenly without any
precursory complaint, but most frequently after having been pre-
ceded by inflammation, which has neither been resolved nor con-
Terted into an abscess. The disease called Scleroma is a species of
Scirrhus, most frequently forming about the neck of the womb, and
having also some swelling, but less resisting, and attended with mode-
rate pain. These are accompanied with displacement to the oppo-
site parts, swelling powerfully resisting in proportion to the pain,
with heaviness and difliculty of motion, not of the limbs only but
of the whole body, and aversion to exertions. When not properly
cured, a dropsical cachexia supervenes. In the commencement, we
must have recourse to venesection, or purging with the hiera of
Archigenes ; then to cataplasms of dried figs, oesopum, nitre, or
344 PAULUS iSOINBTA.
wormwood, and cupping with scarificatioos ; and to the soothing'
ointments {malagmata), namely the Polyarchiam, that from seeds,
and that from hay-berries ; to hip-baths prepared with the decoc-
tion of dried figs, mugwort, penny-royal, and marshmallows ; to
pessaries of turpentine, galbanum, m3nTh, iris, and the sordes of
unwashed wool ; to dropaces and the use of the natural baths, namely
the nitrous and bituminoHS. When the strength permits,, a course
of hellebore may also be tried.
Am Emollibnt Pessary. — Of Pontic wax, of nu*d ointment, of
each, oz. iii. ; of the ointments of iris, that of privet, and that called
Gleucinum, of each, oz. ii. ; of bears and swine's fat, of butter, of the
sordes of unwashed wool, of stags' marrow, of turpentine, of each,
oz. i. Another : — Of poley, dr. ii. ; of myrrh, dr. iv. ; having
triturated with Mindesian wine, and mixed it with Irinum, g^ve to
he applied. Another : — Of Tuscan wax, of the fat of calves, of
turpentine, of stags' marrow, of Attic honey, of old oil, equal parts.
The foUowing is an alterative which answers also for inflation : — Of
the dried white grape without its stones, oz. iii. ; of the leaves of
the green rue, oz. ii. ; of sea-water, oz. i. ss. ; of cumin, dr. iv. ; of
honey, q,$. ; having anointed the pessary, dip it in the oil of privet,
and apply- -^^^ ^^^ pessary called Golden, the Libanian, and the
Enneapharmacus suit well with this affection ; but the Titian ia more
particularly applicable.
LXIX.— On the Mole.
Thb Mole, too, is a scirrhous tumour, forming sometimes at the
mouth and sometimes in the body of tbe womb, conveying to the
touch the sensation of stone, and being attended with retraction of
the parts above, and emaciation, paleness, loss of appetite, re-
tention of tbe menses, and swelling of the breasts, so as in certain
cases to raise suspicions at first of a conception ; but in process of
time the true nature of the complaint is developed. Sometimes
also it raises suspicions of dropsy, from which it is to be distin-
guished by the hardness of the swelling, and ^m there being no
sound of water when tapped by the fingers, as is the case in dropsy.
In certain cases, however^ the disease actually terminates in dropsy,
which for the most part proves incurable. In some cases it also
brings on a discharge of blood. In general, therefore, it is proper
that the patients should lie in a small, dark, and moderately cool
house, upon a firm couch, with their feet raised, and in a state of
quietude ; for motion provokes discharges of every kind. And the
swelling and hardness are to be cured by the remedies which ¥re
have mentioned for scirrhus and scleroma of the uterus ; dropsical ef-
fusions by those recommended for dropsy ; and hemorrhages by those
for the flux. Some call by the name of mole an unorganized mass of
flesh which forms on the coats of the womb, and is delivered like a
foetus. This species is to be managed by a relaxing treatment, so
as to be speedily discharged.
BOOK THIRD. 345
LXX. — On Inflation of the Uterus.
Thb Uterus becomes distended with air from cold, from abortioOy or
difficult parturition ; its mouth being shut up, or a clot of blood being
fastened in it. The air is sometimes contained in the cavity of the
uterus itself, and sometimes in the cells of its body. These cases are
attended with swelling of the pubes and hypogaetrimn, with hardness,
and a pungent pain, shooting as far as the diaphragm, the stomach,
and the groins. When tapped with the fingers, it sounds like the
swelling of tympanites. Wherefore it is to be cured, in the first place,
by venesection, if nothing prohibit its use ; and then, during the
exacerbations, by abstinence from food ; by embrocations with
oil of rue ; by hip-baths of the decoction of rue, of penny-royal, of
mugwort, of cassia, and the like ; by cataplasms from the seeds of
parsley, of cumin, of fennel, of anise, of bishop's-weed, and of the
flour of iris ; by dry cupping, and cupping with scarifications. But,
when the complaint is protracted, we must have recourse to pur*
ging with the hiera picra, dropaces, sinapisms, and the use of the
natural baths. Let the midwife introduce her finger well oiled,
and extract gently, if possible, the thrombus lying in the womb by
breaking it down, and then apply a cataplasm of figs, of nitre, and
of wormwood. £mollient epi themes should be used, such as the
Polyarchian, that from seeds, and that from bay-berries. The pes-
saries should consist of rue, honey, and nitre ; but the following
one will be particularly applicable : — Of fat figs pounded, dr. i. ; of
cumin, dr. ii. ; of aphronitrum, dr. i. But, owing to its acrimony,
let it be previously dipped in milk. Emollient pessaries are also
proper.
LXXI. — On Uterine Suffocation, or the Hysterical Convulsion,
Utbrinb suflTocation is a rising up of the Uterus, affecting sym-
pathetically the most important parts, as the carotid arteries, the
heart, and the membranes of the brain. Those who labour under
it experience, when the attack is at hand, langour of mind, fear,
atony of the limbs, paleness of the countenance, and sadness of the
eyes; and, when the suffocation comes on, there is deep sleep»
mental aberration, loss of the senses and of speech, with contract
tions of the limbs ; the cheeks then begin to redden, and the coun-
tenance becomes turgid ; but, when the attack is going off, some
moisture is to be felt about the genital organs ; and rumbling of
wind in the intestines precedes the remission. The Uterus is then
gradually relaxed, and thus they recover their understanding and
senses. The disease comes on periodically like Epilepsy, and is oc-
easioned by the Uterus being gorged, or from semen or some other
matter having become putrid in it. Of those attacked with it the
greater number speedily recover, but some die suddenly during the
paroxysms, their pulse becoming dense and palpitating irregularly,,
34(i PAUJUUS iSOINSTA.
and then asphyxia taking place ; a little perspiration bedewioff the
surface of the body ; and the respiration bcK^oming at first re^le
bat afterwards completely stopping. This affection attacks most
frequently in winter and autumn, especially young women who are
prone to venery, the barren particularly, if their sterility be brought
on by medicines, and others afiected with cold. During the pa-
roxysms, therefore, ligatures are to be applied around the extre-
mities, and the limbs and whole body rubbed as for the recovery of
persons in deliquium animi. Things of a strongly-fetid smell are
to be applied to the nose, such as an extingui^ed lamp, castor,
liquid pitch, gum vernix, burnt wool and rags. Some have even
bn)ught close to the nose a chamber-pot containing stale urine or
ftsces. It answers well to apply a cupping- instrument to the groins
and hypogastrium, with great heat, either performing dry cupping
or capping with scarifications. When the complaint is protracted,
carminatives will prove useful, such as collyria introduced into the
anus, or cumin and nitre with honey. Hardened feces may also be
dtacharged from the bowels by means of clysters, lest, by ^eir pre-
sence, tiiey occasion pressure ; and, in order to draw back the uterus
to its situation, fragrant ointments are to be injected into the parts,
such as those of marjoram and Indian leaf. Mustard may be ap-
plied to the nose, and likewise to the feet, in the form of a cata-
plasm. One should call aloud to them in a shrill tone of voice,
and rouse them thereby ; and stemutories of castor, fuller's herb,
and pepper, may be applied. When the parox3rsm remits, we may
compel them to vomit, and keep them from food altogether, or
allow them but little. After the seventh day, we must purge them
with the hiera from colocynth. After the third, we must apply
cupping- instruments to the loins and flanks, and then we may give
a draught of castor, sometimes in a decoction of mugwort and some-
times in honied-water ; for, in some cases, this sdone is sufficient
for a complete cure. But hip-baths and emollient pessaries are also
to be applied. Such is the treatment for the paroxysms ; but, for the
recovery of the general system, we begin with venesection and pro-
ceed to purging with hiera, and then give the medicine called picra
from aloes to the amount of dr. i. with three cupfuls of honied-
water in succession, or dr. ii. with six cupfuls at intervals. Dropaces,
cuppingy and sinapisms, must also be used, and the acopa from
euphorbium ; then exercises, friction, vociferation, and, last of all,
the use of the natural baths.
LXXII. — On Prolapsus Uteri.
Prolapsus of the Uterus takes place rarely indeed, but from a
variety of causes ; for it is occasioned either by a woman's idling
from a height and pitching upon her bottom, whereby the ligam^ts
are ruptured which keep the viscus in its position ; or, by the tear-
ing away of the secundines, which drag the uterus along with them
when they adhere, as in difficult labour ; or, by the awkward per-
BOOK THIRD. 347
furmance of embryotomy ; or, by a blow» or mental emotions* sucb
as when tbe loss of children has been communicated, or an irrup-
tion of the enemy, or by a dangerous voyage, or some such cause,
by which the uterus has fallen down, owing to a relaxation of the
whole system, or owing to paralysis and atony of the parts, which
happens most especially to those in the decline of health. It is
towards its moudi that it falls down. Some, indeed, have related
that the whole uterus has been prolapsed, which is incredible ; for,
bow could it have been reduced and fixed in its place ? Wherefore
we must first evacuate the hardened faeces by a clyster, and bring
about a discharge of the urine, in order that the uterus may be
freed ^m all compression, and then place the patient in a supine
position, having her bottom elevated, her thighs bent, and her legs
separated ; and then take a hasp of wool, in figure and thickness
resembling the female vagina, and this being bound round with
a slender piece of cloth, and dipped in the juice of acacia, or of
hypocistis dissolved in wine, is to be applied to the uterus, and all
the projecting part pushed upwards gently, until the whole swel-
ling is restored to the vagina; after which the pubes is to be
covered externally with a piece of sponge squeezed out of oxycrate ;
and the woman is to be laid with her legs stretched out and applied
so that the one may lie over the other. After this, cupping-instru-
ments with much heat are to be fixed to the navel and the loins on
both sides, and things of a ^grant smell applied. On the third day,
while the wool is still remaining in the vagina, let the woman sit
in a hip-bath of dark-coloured austere wine slightly warmed, or in
a decoction of myrtle, lentisk, and pomegranate rind. After these
things, let the wool be taken away and another fold applied soaked
in the medicine. Cataplasms are to be applied externally to the
hypogastrium, of dates, polenta, or dried lentils, and pomegranate
rind with ox3nmel. And every third day let the same thing be
done, until the cure be completed. But, if the prolapsed part can-
not be reduced, and mortify in the course of time, we may take it
away without apprehending any danger ; for' they relate that the
whole uterus, having become mortified, has been taken away, and
yet the woman has lived.
LXXIIL — On Phimus in the Uterus.
Thb mouth of the Womb is shut up either in consequence of
ulceration or of inflammation terminating in scirrhus. We must
cure it by emollient hip-baths of oil and water, and of the decoction
of fenugreek, applying cataplasms of a like kind, and introducing
emollient pessaries. But, if the complaint be protracted, we must
have recourse to vapour baths and fumigation with aromatics. The
Phimus may be dissolved by a pessary of the sordes of unwashed
wool, nitre, and turpentine-rosin, being simply an obstruction of
the mouth of the womb.
348 PAULUS iEGINETA.
LXXIV.— 7%e Cure of Sterility.
It is a common direction, applicable both to the man and the
woman, to preserve the whole body in a proper temperament, by
exercise, food, baths, and every thing else in moderation. What
is most especially to be attended to is, not to allow them to get into
a fat habit of body ; for fat persons are unfit for the propagation of
children, owing to the want of agreement in their genital organs,
and because they do not emit much semen. Nor are those who are
much emaciated more so. All things which are heating and mo-
derately flatulent assist, such as taking heating wine in moderation ;
and of pot-herbs, the rocket, clary (horminumj, hedge-mustard, and
the like ; but they must, by all means, abstain from calamint and
rue. When conception will not take place, owing to some caco*
chymy, we must purge it away, or dilute it with a proper diet.
But women must attend particularly to the state of the uterus, and
that the menstrual evacuation be not obstructed. When, therefore*
the monthly purgation is near, the woman must attend particularly
to take food and drink in moderation, and also some of those things
which promote the discharge, such as the fragrant and acrid pot-
herbs, as scandix, samphire, fennel, parsley, and alsander. And
the intemperaments must be rectified. Wherefore the cold intem-
peraments of the uterus are indicated by retention of the menses,
a cold and incrassating diet, and some torpor about the pubes, loins,
and legs ; and these persons, if they become perfectly congealed in ha-
bit, have no venereal desires at all. Wherefore we must endeavour,
in every other way, but particularly by all kinds of fomentations, and
by fumigation with aromatics, to recal the natural heat. And it
will not be at all improper to drink of castor and of some of the
aromatic seeds, such as cumin, anise, the flowers of penny-royal,
and the fruit of junipers, mixing some pepper with each. Fumi-
gations of the womb may be applied either by sitting on a proper
chair, and receiving the vapours which arise, or by injections of
hot water in which sage, mugwort, rue, cumin, penny-royal, sweet
flag, and the aromatic seeds, have been boiled. A cataplasm of any
of them may also be applied to the lower part of the belly. The
epitheme of Polyarchus is also appropriate. Frictions of the lower
part of the belly and nates are no less proper. The woman may
also use pessaries of myrrh, rue, galbanum, and castor, having pre-
viously fomented with honied-water or salt water. The pessary
called Gon^ is also an excellent one. Warmer intemperaments of
the uterus are indicated by the whole body being hotter than usual,
by the menses being voided in small quantity and with pain, and
by the privy parts of the woman being ulcerated. They are to be
remedied by such things as are moderately moistening and cooling,
such as the pot-herbs, lettuces, mallows, blite, gourd, cucumber,
pompion, orach, and purslain, and by the other articles of food of
a like nature ; and we must apply to the bladder, abdomen, and
loins, all cooling things, such as cataplasms and liniments made of
BOOK THIAO. 349
the juices of herbs. If the woman cannot conceive owing to hu-
midity of the uterus, it is indicated by there being much moisture
of the parts during the venereal act, and by the menses being thin
and in great quantity. A desiccative diet, therefore, suits with
these cases ; also exercise and frictions of the upper parts ; emetics,
and dry food in moderate quantities. It will likewise answer well
to strengthen the uterus by sour medicines, such as the decoction of
lentisk, of myrtles, of roses, and of sumach ; or, also by that of
pomegranate flowers, of the tender shoots of bramble, and of galls.
When the uterus is drier than common, it is to be cured by the op-
posite remedies, I mean by baths and unguents, a moistening diet
of pot-herbs, wine in moderation and that not very old. But, if
conception be prevented by thick humours, and if they be of a pun-
gent nature, the woman must be purged in a way suitable to each
humour, and more particularly with the picra from aloes ; then an
injection with the whey of women's milk is to be administered, and
a more suitable diet thought of. Pituitous humours are to be eva-
cuated by exercise, sudorifics, and emetics, or downwards by the
belly. The following medicine may be given: — Of dodder of
thyme, of euphorbium, of pepper, of carrot-seed, of the seed of
Macedonian parsley, equal parts ; triturate all together, and give
to the amount of two drams to drink. This purges well and heats
the womb, so that it often makes the menses flow in cases where
this discharge was stopt. As soon as this correction has become
apparent, and the menses flow properly, then one must enjoy the
woman as soon as the menstrual evacuation stops. When flatus in
the womb prevents conception, the symptoms of which may be re-
cognised from what we have said on Inflation of the Uterus, it is to
be cured flrst by a spare diet, and administering cumin, dill, parsley-
seed, and that of rue and anise ; and by giving many of the aroma-
tics, some to drink and others by pessaries. When the mouth of
the uterus is shut up, it must be opened by injections of aromatics,
and by using fomentations from mallows, linseed, fenugreek, and
oil, and sometimes of honey ; or, by the stronger ones, composed
ef mngwort, flea-bane, calamint, penny-royal, and camomile. In
addition to these, we may use turpentine, nitre, wild cucumber, ela-
terium, cassia, and tar- water. When the mouth of the womb gapes,
the diet, fomentations, and medicines, should be of a desiccant na-
ture and astringent ; and the flowers of pomegranates, lentisk, the
roots of brambles, myrtle- berries, and those things applicable for a
humid intemperament. Distortions of the uterus are to be rectified
by fomentations and emollient pessaries. In such cases, coition a
posteriori would seem to promote conception.
LXXV. — On Fissures y Condylomata^ and Hemorrhoids of the
Uterus,
Fissures occur about the mouth of the Uterus from difficult par-
turition, and at flrst they escape notice while the pains from the
350 PAULU8 iSQINBTA.
labour are recent ; but afterwards they are slightly felt, either upon
mannal inspection or daring coition, when they bleed, owing to the
friction. They are also discovered when the vagina is distended,
for ruptures in the circle of the mouth are perceived. In these
cases all surgical aid, and medicines of an irritating nature, must be
avoided ; and recourse had to the simpler hip-bafiis and pessaries.
The medicine called Tetrapharmacon dilated is befitting. But, if it
be callous, we must use that from paper, with rose^l. If they
cannot bear the strength of it, mix Ill3rrian iris with turpentine, and
apply it. When the ulcers are cicatrized, it will be proper to use
the medicine torn cadmia, or some of the applications to the anus,
such as that from litharge. It sometimes happens that these fissures,
becoming chronic, are converted into condylomata, in which case
the callus is to be removed by similar remedies, and the condylo-
mata cicatrized. Hemorrhoids form about the mouth and neck of
the uterus, which will be discovered by the Dioptra ; for eminences
may be detected which, during the exacerbations, are painful,
bloody, and red, but, during the remissions, are wrinkled, free
from pain, somewhat livid, and emit a slight discharge. If possible,
therefore, in these cases, one must seize upon them during the re-
missions with a forceps and cut them out ; or, if not, we may touch
them with astringent medicines, sometimes applying dried pome-
granate rind with galls, or something such ; and sometimes using
those recommended for hemorrhages of the uterus, which will apply
bolii for fluxes and hemorrhoids. These are recognised by the
uterus discharging blood constantly, or, if at intervals, not in the
menstrual period.
LXXVL— 0» Difficult Labour.
Difficult Labour arises either from the woman who bears the
child, from the child itself, from the secundines, or from some ex-
ternal circumstances. From the woman in labour, either because
she is gross and fat ; or, because her whole womb is small ; or, be-
cause she has no pains ; or is affected with fear ; or, because the
uterus or some other part is inflamed, or otherwise diseased ; or,
because, from some natural weakness, she is unable to expel the
foetus ; or, because the labour is premature. From the child, either
because it is too large ; or, small, and of little weight ; or, from its
having a hydrocephalous head ; or, from being a monster, such as
having two heads ; or, because it is dead ; or, although alive, be-
cause it is weak and unable to advance outwards ; or, because there
happens to be several children, as Herophilus relates a case of five;
or, because the position is preternatural. For the natural position
of the child is, first, when its head presents with the hands bent
upon the thighs, and having its head directly applied to the mouth
of the womb ; and, next to that, when it descends by the feet, and
there is no retroversion. All the other positions except these are
-preternatural. Or, from the secundines, either because the mem-
BOOK THIRD. 351
branes cannot be torn, owing to their thickness ; or, because they
have been torn prematurely, owing to their thinness; for, when
the waters are evacuated unseasonably, the fcetus gets out with dif-
ficulty, from the dryness of the parts. From external drcnmstanoes,
either from cold contracting or immoderate heat dissipating the
powers, or from some accidental occurrence. Wherefore, if the dif-
ficulty of parturition arise from constriction, and, as it were, impac-
tion of the foetus, we must first endeavour to produce relaxation by
injecting frequently hot sweet- oil with the decoction of fenugreek, of
mallows, of linseed, or with eggs, as a paregoric. Then we must
apply cataplasms to the pubes, abdomen, and loins, of linseed, or of
honied- water, or of oil and water ; and use hip-baths of a similar
nature. We mast also avail ourselves of the relaxation produced
by baths, if neither fever nor any other cause prohibit; and the
woman is to be moved on a couch in a moderately warm air. Some
have bad recourse to powerful shaking, and have applied sternuta-
tories. If the woman be in low spirits, she is to be encouraged ;
and, if she is inexperienced in labour, she is to be directed to keep
in her breath strongly, and to press down to the flanks. If she be
in a swoon, she is to be resuscitated by such strong-smelling things
as are not stimulant ; and, when moderately recovered, she is to be
supported with a little food. A woman that is fat is to be placed
in bed in a prone position, bending her knees upon her thighs, in
order that the womb, being carried to the abdomen, may present
with its mouth direct. By means of the fingers, the mouth is to be
smeared with cerates or fatty substances, and gently dilated. And,
if there be any complaint in the parts, it must be previously at-
tended to. And hardened faeces when retained must be expelled
by an emollient clyster. The membranes may be divided either by
the fingers, or by a scalpel concealed within them, the left hand
directing it. And some of the fatty liquids may be thrown up into
the uterus by a sirringe. When the foetus is in a preternatural
position, we may restore the natural position, by sometimes press-
ing it back, sometimes drawing it down, sometimes pushing it
aside, and sometimes rectifying the whole. If a hand or foot pro-
trude, we must not seize upon the limb and drag it down, for there-
by it will be the more wedged in, or may be dislocated, or frac-
tured ; but, fixing the fingers about the shoulders or hip-joint of
the foetus, the part that had protruded is to be restored to its
proper position. If there be a wrong position of the whole foetus,
attended with impaction, we must first push it upwards from the
mouth of the womb, then lay hold of it, and direct it properly to
the mouth of the uterus. If more than one child have descended,
they are to be raised upwards again, and then brought downwards.
Every thing is to be done gently and without pressure, the parts being
smeared with oil. The time for placing the woman on the stool is
when the mouth of the womb is open and meets the finger, and
when rupture of the membranes is at hand. If, owing to the death
of the child, or any other cause, it do not advance, we must proceed
to embryotomy.
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BOOK THIRD. •**''^
plex. The natural baths also are proper ; or, if these be not at
hand, they may bathe in the others ; using the restorative ointments
formerly mentioned, and the compound ones, — the iEsculapian, and
that composed of equal portions of euphorbium, adarce, black helle-
bore, castor, pellitory, pepper, and wild grape dried. After the bath,
we must sprinkle upon the skin while still warm, of dried pitch,
oz. iii. ; and of native sulphur, oz. ii. ; and let the part be covered
with paper. If even these things do not succeed, a remnant of the
disease remaining, it will be proper to apply a cataplasm of mus-
tard along with dried figs, or by itself. These complaints are com-
pletely removed by the Iberian herb, which some call Lepidium,
and some the wild Cardamus (cress). And the shrub which grows
among us, having leaves resembling those of the bay, but much
larger, is of approved efficacy, not only in ischiatic, but in other
chronic complaints ; but it is by far most efficacious in summer.
Or, if it should not have shooted out its leaves, we must bruise the
rind of the root with axunge, so as to form a plaster; and then,
spreading it on a thick rag, apply to the parts affected with the pain,
namely, to the whole buttocks and thighs ; and allow it to remain
until the part become black, or, at all events, until the cuticle be-
come livid; then take it away, and, having washed, apply this
cerate : — Of opoponax, oz. iv. ; dissolve in ii. cyathi of vinegar ;
and add to the cerate of privet. If they do not admit the use of
such caustics, we must use the plasters called Extirpative, among
which is the following : — Of wax, of pine rosin, of each, dr. xii. ;
of wild ptgeoufi dung, of recent lees of wine burnt, of each, dr. vi. ;
of galbanum, dr. i. ss. And the plaster called the Lioness is of the
Extirpative kind. Those composed from strained lye and nitre are
also proper. And some have continued to drink certain potions for
a whole year, among which is the one composed of four ingredients :
— Of wall-germander, lb. i ; of gentian, oz. ix ; of round birth-
wort, oz. ix. ; of the dried seed of rue, i. sextarlus : pound these things
together, sift, and give every day a spoonful to the patient when he has
an «mpty stomach and his digestion is good, with two cyathi of cold
water; «nd continue this for a year, until the complaint cease. And
the medicine composed of seven ingredients, and that which takes
its name from Proclus, are of the same reputation. Exercise may
be taken by walking, frequent bending of the body, leaping, and
running. The food should be moderately attenuant and digesti-
ble. If ischiatic disease do not yield to any of the remedies now
mentioned, it sometimes terminates in suppuration ; and some-
times, from a relaxation of the ligaments, the thigh is dislocated at
the joint. Wherefore, when the affection is protracted, we must
bum the joint in three or four places (as will be described in the
Surgical part of the Work), and the ulcers are to be kept open for
many days.
A a
354 PAULVS iEOINBTA.
LXXVIII.— 0» Gout and Arthritis.
t
It is not weakness of the parts alone that occasions Gouty and
Arthritic complaints ; for then the paroxysms wonld be without
ceasing, inasmuch as the debility is always present in the weak
parts. Neither is a humour the sole cause, for then the complaint
had not attacked the joints only. But the disease is occcusioned by
a preternatural humour and a weakness of the parts meeting toge-
ther. For, when the nutritive power of the parts becomes debili-
tated from repletion with food inducing dyspepsia, the prevailing
humour, fixing in some of the joints which are already in a weak
state, and stretching the nervous ligaments, produces pain. For,
the inflammation is not an original affection of the nerves of voli-
tion ; as then it would have affected also the parts between the
joints, such as the middle of the legs, thighs, arms, and fore-arms ;
but those of volition are affected sympathetically. When, there-
fore, the humour is seated in the joints of the feet only, the com-
plaint is called Podagra ; but, when the cause is diffused over all
the joints of the body, we commonly call it Arthritis, in which the
vertebrae, scapulae, jaws, and every other joint are attacked with the
disease. In certain cases, the ears, teeth, and pharynx, and some-
times even the liver and spleen participate in the arthritic pains,
when, if there is not a speedy translation of the disease to the joints,
the patients will be in urgent danger. The 'prevailing humour is
sometimes bilious, sometimes sanguineous, sometimes melancholic,
but for the most part it is pituitous and crude, being engendered by
excess of food, indigestion, and want of exercise. When the dis-
ease is protracted in the joints, the humours become thick and
viscid, so as to form what are called tophi or chalk stones. Some-
times the humour is of a compound nature, so that the disease is
difficult to distinguish, and difficult to cure, or nearly incurable.
The precursory causes of this aflection for the most part are immo-
derate labour, violent walking, frequent exercise on horse-back^ the
unseasonable use of venery, cold drink taken unseasonably, eating
of much cold or unwholesome food, and drinking much wine. And
some from accidents, as a blow, a sprain, or the like, have experi*
enced the first attack of this complaint, the materials of lite disease
having previously remained quiet in the system until roused by the
proximate cause. Sorrow, care, watchfulness, and the other pas-
sions of the mind, not only excite an attack of the disorder, bot
also generate a cacochymy either primarily or incidentally. Tbe
causes of the complaint, as I have said, are various ; but the dif-
ferences of the noxious humours are in so far easily detected, being
discovered by their colour and other symptoms. A bilious rheum,
in addition to paleness and redness of colour, occasions a sensation
of heat and acute pain, and is speedily determined to the skin, nor
is it attended with much swelling. It is exacerbated by heating ap-
plications, and relieved again by cooling, which, for the most part,
is the case with all the others, but more particularly when the ex-
BOOK THIRD. 355
citing cause is bilious. Fever also frequently cumes on at the
height of the paroxysms, and then they are thirsty. Thus also you
will find the skin darker when from a melancholic humour ; white
and watery when from a pituitous, in which case the pain is more
latent and more slowly occasions swelling ; and the colour is san-
guineoas when a bloody humour prevails. In order to form a more
dedded diagnosis, yon will be assisted by taking into account the
previous mode of life, and so forth.
Tbs Curb of Rhbums prom a Bilious Humour. — ^The com*
m^icement of the care when from yellow bile, more especially if
the quality of it occasion the disorder, should be the evacuation of
the ofiending humour by purgative medicines, such as that from
rbodomel, that iicom quinces, the antidote called picra, and aloetic
pills. Ihuing the paroxysms, we may apply externally rose-oil
with the yolk of an egg, and some wine, rubbing the part gently
with it; and apply the herbs of a cold nature, such as night> shade,
[Hirdlain, hen-bane, house-leek, marsh lentil, endive, poppy, knot-
grass, rose-leaves, and the like. These things may be sometimes
rubbed in, and sometimes applied in the form of a cataplasm, with
crumbs of bread soaked in oxycrate, or from barley-meal with rose-
oil. When the inflammation of the joints is of an erysipelatous na-
tvre, a decidedly paregoric application is the peel of a fresh gourd
laid on the part, or the fleshy part of a pompion or cucumber,
both akme and with bread ; or, the leaves of perdicium (polygonum
maritimumPJ, and ivy with bread and fine polenta. And flea- wort
boiled in bsurley-flour mitigates the inflammatory heat in a wonder-
ful manner ; and so also the rose-cerate cooled with some of the
frigorific juices, and that prepared from the flour of beans. It is
prepared thus : — Of wax, oz. v. ; of camomile oil, oz. ii. ss. ; of
rose-oil, oz. ii. ss. ; of the flour of beans, oz. ss. ; the yolks of ^ve
eggs. Another, a cataplasm : — Pound green mallows boiled ; and,
having made flea-wort to the consistence of bird-lime separately,
mix together ; liien add the red part of eggs and camomile oil, and
apply as a cataplasm. When the pain is great and difficult to en-
diire, we must have recourse to preparations of saflron, of horned
pop^y, and of opium, triturating them with oxycrate, and then
using them in the form of liniments, or of cataplasms with crumbs
of bread. Gaimi makes mention of this one: — Of poppy-juice
(epiumj, dr. iv. ; of saflron, dr. i. ; triturate with milk of a cow or
of a goat ; or, add the inner-part of bread, and, having softened it
by touching it with a little rose-oil, use for a cataplasm. Or, tri-
turate the opium and saflron with the milk, and add to the rose-
cerate. And the cerate made from the torpedo, and the oil of the
same, are possessed of similar properties. And this one in like man-
ner :— Of crumbs of bread soaked in water or in oxycrate, and of
house-leek, or of night-shade, or of purslain, and of the fleshy parts
of dates, and of poppy- seeds, equal parts ; of roasted yolks of eggs
and rose-oil, q, s. : form a cataplasm. The use of narcotics must not
be continued, but only until the violence of the pain be abated ; for
the frequent use of them occasions impaction and tophi, and makes
A a 2
356 PAULUS iEGINETA.
the difficulty of motion to be protracted. After the use of anodynes,
then, we must have recourse either to diachylon dissolved in oil of
camomile, or the composition from marshmallows, or some such ap-
plication. After we have warmed the congealed parts, we must
strengthen them by a plaster of dates dissolved in vinegar and rose-
oil, or wine and rose-oil. Or, if the weight of the plasters prove
troublesome, we may rub in the juice of acacia with oxycrate, or
lycium along with saffi-on, homed poppy, and the juice of perdicias
in oxycrate. The diet should be cooling and moistening, such as
ptisans, and spoon-meats from chondrus, and of pot-herbs, the mal-
lows, the lattuce, and the endive ; and of birds, more especially the
young of domestic fowls ; and of fishes, those caught in rocky places,
and the sea-urchin, shell-fish, and the like. Let thei^ avoid idl things
that are heating and form pale and yellow bile, cid wines both the
yellow and dark, and repletion. Let them use baths of sweet
water, even at the time of the defluxions, as far as regards the cause
of them, unless something else prohibit. Let them avoid violent
passion, abstinence, acrid food, drinking of wine, immoderate la-
bour, and venery.
Thb Curb of Rheums from a Sanguineous Humour. — In
those cases in which the prevailing humour is sanguineous, we must
have recourse to venesection without delay, and also in cases where
the prevailing humour is phlegm or black bile ; since in them the
humour is for the most part contained in the veins, proving inju-
rious by its quantity rather than its quality. We must have recourse
then to venesection at the first attack of the disease ; since those
who have had already frequent attacks of rheumatism are injured
rather than benefited by the loss of blood, more especially when
the body is naturally cold or -weak. After the evacuation of the
blood, if there was more than a plethora of blood, we must have
recourse to purging with hiera after a short interval. And the
Julian oxymel is a purgative suitable to these cases. Those who
reject such purgative medicines may use these pills : — Of aloes, of
coloc)mth, of black hellebore, of ecammony, of each, oz. i. ; of
euphorbium, oz. ss. ; of nitre, oz. ss. ; mix with the juice of cab-
bage, and give according to the patient's strength. It will be bet-
ter, however, if prepared with the juice of quinces. Another pill
given to gouty persons in the paroxysms, during the remission, and
from whatever humour : — Of aloes, oz. vi. ; of agaric, oz. ss. ; of
safifron, oz. ss. ; of costus, oz. i. ; of spikenard, oz. i. ; of schenanth,
oz. i. ; of balsam fruit, oz. i. ; of cassia, oz. ii. ; of scammony, oz.
ii. ; of dodder of thyme, oz. iii. ss. A moderate dose is scr. ii. ; and
a full one, scr. iv. Pills of Armenian stone also purge in a won-
derful manner, being particularly applicable in arthritic cases,
whether given at the commencement, in the decline, or during the
remissions of defluxion. And, since some avoid scammony becauae
it is bad for the stomach, we may give them these things when a pitui-
tons matter prevails : — Of the medullary part of colocynth, of black
hellebore, of bdellium, of gum, of aloes, of each, oz. i. ; of Alex-
andrian nitre, of euphorbium, of each, oz. ss. The dose is scr. iv.
ft BOOK THIRD. 357
Instead of the gum, I have substituted dodder of thyme. Some in
the paroxysms of all arthritic diseases have recourse to purging
with hermodactylus ; but it is to be remarked, that the hermodactylus
is bad for the stomach, producing nausea and anorexia, and ought,
therefore, to be used only in the case of those who are pressed by
argent business ; for it removes rheumatism speedily, and after two
days at most, so that they are enabled to resume their accustomed em-
ployment. J knew a person who did not give the substance of her-
modactylus, nor any of the compound medicines containing it ; but,
boiling the plant itself with some of the common remedies, such as
anise or parsley, he gave the decoction to drink ; and it was won*
derful how those who got it, having evacuations of the bowels, were
freed from the rheumatism. It is necessary, however, as I said, be-
cause the medicine is bad for the stomach, to correct the mouth of
the stomach by stomachics and tonics, along with things that are
moderately heating. Alexander says, that purging by coronopodium
is preferable to that by hermodactylus, as it procures evacuation and
relief from pain, and, at the same time, is not bad for the stomach.
But topical applications are to be had recourse to in cases of pitui-
tous rheumatism. When the pain is moderate, a green cabbage
leaf maybe applied, and parsley, flea-bane, and the straight ver-
vain ; but, when the pain is violent, take of the flour of fenugreek,
p. iii. ; of the flour of darnel, p. i. ; of the flour of chick-peas, p. i. ;
make a cataplasm with honied- water, or thin wine, with a little oil
of privet, or of nard, more especially if in winter. And the ashes
of burnt cabbage roots, or of their stalks, when formed into a cata-
plasm with axunge, have proved beneficial to many ; but, in order
that it may prove soothing, the axunge must be fresh, whereas, if
we wish it to be discutient, it must be old and salted. And, in
Uke manner, the dung of oxen when boiled in honied-water with
barley-meal, or fresh moist dung applied with the leaves of cab-
bage ; and so also goats* dung by themselves, or boiled with barley-
flour in oxycrate. And, since some have derived relief from seem-
ingly opposite remedies (for a mixture of various humours confounds
the diagnosis), we must state the materials thereof promiscuously.
Wherefore the wild and garden orach in a cataplasm with bread are
beneficial, or the leaves of petty-mullein, triturated with the bulbi
and bread, or with polenta, or the cataplasm of raw barley-meal.
Upon the whole, when the cause of the complaint is obscure, we
must change sometimes to medicines of the same class, and some-
times to the opposite, not continuing long with the same applica-
tion when it does not afibrd relief. These things we see every
day occur in professional matters. And often a certain remedy
proves beneficial to one joint, while another joint of the same patient
similarly inflamed is not only not benefited at the same time, but
occasionally is even injured by it. And this is a wonderful circum-
stance, that one and the same joint, when treated with the same
remedy, is sometimes benefited, and soon afterwards exasperated.
When a viscid and thick matter prevails, it is not perhaps relieved
by calefacients, but the acrid and hot quality of the humour pre-
368 PAULUS iSOINETA.
vailing is to be soothed by frigorific remedies; nor is it at all
wonderful, that a matter naturally cold, in the time of the inflam-
mation, should become heated and glowing, to say nothing of the
admixture, perhaps, of bile. The flour of lupines with ozymel or
oxycrate, or the root of laser- wort, or of bryony, with bread, pre-
vent the formation of Tophi. And the following composition is
safely soothing, and moderately discutient : — Of lycium, oz. i. ; of
ammoniac peifume, oz. i.; having triturated with very old wine»
and oil of unripe olives, boil, and add of the flour of beans, q. «.;
and, having boiled moderately, apply as a cataplasm. After the
acm^ of the complaint, if a swelling be left, apply a cataplasm with
the balbi by themselves, or with fine polenta, until it produce exco-
riation ; for in this manner they act. When not relieved by the
cataplasms, we may have recourse to embrocations and aflfusions on
the parts (more particularly if the extremities be aflected), with ca-
momile, melilot, or centaury in decoctions. The preparation of
cappers has entirely relieved some. The following is the most ac-
tive of all the applications : — Having boiled thyme, maijoram, sa-
voury, and calamint in the most acrid vinegar, bathe the parts
aflected with the vinegar, not only once, but often in a day, with
confidence. This has relieved many when suflering not only from
phlegm but also from bile.
Some observe this also : — ^The acorns of the ilex, being powdered,
are pounded and much boiled^ and the joints of the extremities at
the commencement of the rheumatism are fomented for a con-
siderable time with the decoction, which is poured from a sponge
upon the inner-parts ; whereby the violence of the ofiending mat-
ter is repelled. It also is applicable to bilious cases ; and, in
like manner, immersion in hot water without any decoction. For
pains occasioned by intense cold, or infarction of the joints, this is
a powerful remedy : — Of old oil, lb. i. ss. ; of Alexandrian nitre,
lb. i. ; of turpentine, lb. i. ; of euphorbium, oz. i. ; of iris, oz. ii. ;
of the flour of fenugreek, a sextarius and a half. For these cases
the remedies recommended for ischiatics are excellently applicable.
Many, in the case of those who are thus aflected with a cold cansei
apply, after the acm^, mustard with dried figs and the other rubefa-
cients, but some the preparation from cantharides. But these things
prove injurious afterwards, unless one use the emollient applica-
tions, such as that from fuller's herb, the one called Pyxis, that of
fiasilius, that from the fir-tree, that from the poplar, those called
Promium and Lysiponium, and the stronger of the Acopa : in whieh
cases, sympathetic afiTections of the nerves and impaction of the
humours particularly take place. And the application from the
urine of a mule, more particularly if applied at the acm^, is benefi-
cial in the cold rheums : and, in like manner, the trochisk from the
two hellebores is applicable for the oedematous and spongy swel-
lings ; also, fomentation with the toasted salts ; or otherwise alRi-
sion or embrocation with hot sea water ; and the plasters prepared
from salts, those from strained lye and nitre, and the cata^asms of
a like nature after the acm6. Food of a drier nature, and not ex-
BOOK TUIED. . 350
cremeDtitious, suits well with these ; also« abstineDee from food, or
a spare diet, and refrainiug from frequent baths. Having bathed,
they should be rubbed with nitre and the other unguents used for
friction. In the decline, they should have recourse in particular to
gymnastic exercises, and friction of the joints, and the natural baths,
pr the sand baths, and emetics from radishes and frumentacious
food. Those properly prepared for it may be vomited or purged
with the white hellebore.
On Rheums from a Mixturb of Humours. — ^Those labouring
under a mixture of humours, after the evacuation of the blood at
the commencement of the disease, may use the topical remedies
already mentioned. When the sanguineous plethora is more bilious
and acrid, recourse may be had to those things recommended for
bile ; when it is of a colder and more pituitous or melancholic na-
ture, those afterwards mentioned, with the exception of such as are
very acrid ; and, if protracted, these also may be used. And this
cataplasm is applicable at the commencement : — Pomegranate rind,
sumach, and polenta triturated with wine, are applied in the form
of a poultice. Another: — Having boiled the leaves of cabbage,
and triturated carefully, add the lees of vinegar, two yolks of raw
eggs, and a little rose-oil, and having triturated, apply, changing it
frequently. Let them take food that is attenuant and of little
nourishment. Let them, therefore, abstain altogether from flesh and
pulse, from much wine of a dark colour ; and, if possible, let them
abstain from drinking wine altogether. For I have known many
who have abstained altogether from this article alone, and all of
them derived benefit. Those who did so in the commencement of
the complaint were entirely freed from it ; and those who were later
in doing so experienced afterwards fewer paroxysms, and these not
of great severity. If, therefore, no inconvenience occur, or be
dreaded from it, they should abstain from wine all their life.
Those who from weakness or coldness of constitution appear to
sink imder this regimen, after abstaining from wine for two years,
may gradually accustom themselves to take a small quantity of di-
luted wine. Those who refrain from wine should take instead of
it a decoction of anise, or of some such seeds, avoiding altogether
the use of the autumnal fruits, and other things of a cold nature,
and also venery. Of those who attempt to get rid of the complaint
by continuing under a course of medicines for a complete year,
many who suffer from pituitous and redundant humours have been
benefited thereby, whereas such as are of a hot and dry intem*
perament have brought on sudden death, the offending matter
being translated to the intestines, kidneys, side, lungs, or some vital
part. It is better, therefore, for those who are bilious and sangui-
neous, to abstain from wine ; as from this course there is no risk of
falling into the dangers just mentioned. Those who are affected
with cold and redundant humours should take the theriac of vipers,
more frequently, if they have good digestion, in winter, but more
rarely in summer ; for it either removes the complaint altogether,
or renders it more moderate, and proves injurious to none of the
360 PAULU8 .EOINETA.
afore- mentioned parts. And, since some compel us to administer
the medicines called Antidotes, you should be aware that the fol-
lowing are all of the same kind, namely, that from water plantain,
that of Agapetus, those called Atacton and Octaidon, that of Proclus,
that from water germander, that from coral, and many others. The
safest of them all, and yet of approved efficacy, is the one from
coral, which dissolves tophi that are formed in the joints. The
properties of all these things, the manner of using them, and the
precautions to be observed with regard to them, you will find des-
cribed rn the Pharmaceutical part of this Work ; and also the com-
position of depilatories for arthritic complaints, and the mode of
applying them to these habits, I mean the pituitous. Some, for the
entire removal of the complaint, boil whole wolves in oil, wherewith
they cure arthritic cases — some throwing them in alive, and others
dead, into a large caldron. And in like manner they boil hyaenas, mak-
ing a diseutient oil from them ; and then, filling the cistern of the bath
with it, and putting the arthritic patients into it, they direct to re-*
main in it for a considerable time. By these means, it happens that
not only the swellings about the joints, but the whole body, is eva-
cuated.
On Tophi, or Chalk-Stonbs. — Since Tophi are often formed in
the joints, sometimes owing to a thick and terrene humour seating
in the parts, and sometimes owing to the use oi applicstionff which
are immoderately diseutient and desiccant without being emollient,
it is proper to know that the most suitable remedies are such as are
at the same time emollient and diseutient. Wherefore, old suet,
marrow, ammoniac, bdellium, very old oil, and storax, are emol-
lient ; and nitre, salts, strained lye, adarce, euphorbium, and the
like, are diseutient and desiccative. This is an excellent applica-
tion for tophi in the joints : — Very old and acrid cheese pounded
and applied with a decoction of fat swines' flesh, it also being old.
For, the chalk-stone breaking spontaneously, a discharge of it takes
place every day. The composition from ham (which is prepared in
two ways) is also an approved remedy, and t^ose described from
strained Lixivial ashes. And this one is particularly excellent : —
Of aphronitrum, of turpentine, of protostacton, of virgin wax (i. e.
bee glue), of each, oz. iv. ; of wax, oz. ix. ; of colophonian rosin,
lb. i. ; of oil, oz. xvi. : mix together, and use for chalk-stones and
apostemes. The composition from dragon's-blood is of wonderful
efficacy for chalk-stones and many other complaints, but is difficult
to procure. But that from walnuts is not only efficacious but at
the same time easily ])rocured ; and is applicable not only to those
who are strong, but also to those who are sensitive, if mixed with
honey or the composition from anemone, in the proportion of tw^
parts to one of the composition. When these things are not at
hand, an equal proportion of ceruse may often be mixed with it.
Another for tophi : — Having triturated red arsenic, mix with misle-
toe of the oak, and use. Another, which is applicable also for
fistula and segilops : — Of oil, one sextarius ; of litharge, oz. viii. ss.;
of arsenic, oz. i. : boil the litharge and the. oil until they do not
BOOK THIRD. 361
Stain, then sprinkle the arsenic well levigated, and, before it catch
fire, take off and use. The compositions from the flower of Assian
stone, when used during the intervals, are applicable to all the col-
lections which form in the joints ; and some of the ancients attest
that they remove the complaint entirely. The composition from the
flower of salt, when applied in like manner during the remissions, is
believed to dissipate whatever swellings remain.
On thb Prophylaxis from Gout. — Goat and rheumatism, when
formed, are among the most difficult of diseases to cure, except by
the methods we have described ; but, before being fixed, it is easy
to prevent their occurrence, by restricting the diet, giving only such
food as is of easy distribution and not excrementitious, with a mo-
derate allowance of wine, and increasing the exercise as far as
proper. As a remedy, salts triturated with oil, and rubbed into the
joints, are of great use to all who are anxious to avoid falling into
a gouty affection, unless they be of a dry intemperament. They
ought to use it morning and evening through life, and the same
thing is to be used after the decline of the inflammation.
LXXIX.— On Chilblains in the Soles qf the Feet and Heels.
Chilblains are ulcerous affections that form about the fingers
and toes in the season of winter. They are to be bathed with tepid
sea water, or the decoction of beet, of lentil, of bitter vetch, or of
the root of king's-spear. After this, triturate boiled lentil swith
wine, and apply in the form of a cataplasm ; or, apply figs triturated
with oil ; or, triturate equal portions of alum and barley flour in
wine, and apply y or, use a cataplasm of dried lees of wine or of
fresh bulbi triturated with wine ; or, boil garlic in oil, and, having
thrown away the garlic, melt a moderate quantity of wax with the
oil, and apply ; or, boil pomegranate rind in wine, and, having tri-
turated, add to the rose cerate, and use, having previously fomented
the part with the decoction of lupines ; or, apply manna and native
sulphur with boiled honey. The juice of henbane rubbed frequently
into the part removes the inflammation and pain.
Thb Marcbllian Application kor Chilblains. — Having
scooped out the heart of a turnip, put into the cavity two ounces
of wax, and the same quantity of lentisk oil ; and, having boiled them
in a double vessel, along with sea water, brine, or the decoction of
lupines, bathe the part with the fluid ; and, having cooled the cerate
which is melted in the turnip, apply it. For ulcerated chilblains : —
Of frankincense, of fissile alum, of reddle, of rosin, eqiial parts ; di-
lute with axunge, and use. For ulcers with inflammation, use the
application called Hexapharmacon : — Of oil, oz. ix. ; of bull's tal-
low and gall, of each, lb. ii. ; of litharge, oz. vi. ; of colophonian
rosin, oz. iv. ; of honey, oz. vi.
For FiasuRBS of thb Toes and of thb wholb Fbet. — Anoint
with liquid pitch ; or, having burnt a river or sea-crab on coals,
scrape off the shell, and, having triturated it with oil, and made of
362 PAULU8 i£GIMBTA.
the consistence of honey, and having wiped the fissures* apply.
The inner part of sqaill boiled in oil and triturated with turpentine
also answers well ; and a goat's horn burnt and mixed with azonge.
One must first clear the ^lous part, and then use the medicines*
Thb Plaster callbd thb Florio for Fissurus of thb Hbkls
AND SoLBS : — Of quick-lime, dr» x. ; of ceruse, dr. zx. ; of wax, dr.
XX. or XXX. ; of fresh axunge, oz. vii. ; of colophonian rosin, oz. ix. ;
of the juice of linseed, one oyathus ; of sweet oil, oz. xl. : nothing is
so efficacious for softening the sole. Another : — Of gnats' seam, of
wax, of oil, equal parts ; use. Another : — Having boiled pomegra*
nate rind in vinegar, apply for five days ; then, having deancNl it
away, apply quick-lime with oil, or with bath sordes. Another : —
Having boiled squill in oil, throw away the squill when boiled : add
some turpentine to this oil, and use.
For Frbttino of thb Hbels from Long Confinbxbntin Bbd :
—-Of wax, of oil, of litharge, of honey, equal ^larts. It answers
with every ulcer of the soles, heels, ancles, and inner part of the
toes, more especially if the sore be near the nail.
For Foul Ulcbrs in the Solb, and also for tbosb in thb
Pudendum : To be applied on a Pledget : — Of lees of oil, one
eyathus ; of vinegar, one cyathus ; having boiled in a copper vessel
until of the consistence of honey, and triturated separately with ii.
dr. of the flakes of copper, and ii. dr. of manna, add the ashes of a
handful of soft unwashed wool which has been wrapped round a
torch and burnt : mix all together, and use, diluting it with wine
for wounds, and with must for those of the pudendum and sole.
Another :*-Of lees of oil, of scummed honey, equal parts. This
also cleans the gums.
For Fretting of the Skin by Shoes. — ^The lungs of a lamb, of
a swine, or of a goat, make a good application. The burnt leather
of old shoes does not answer when there is inflammation; but,
when the inflammation is over it answers well. Or, apply onions
with the grease of a fowl ; or, sprinkle the part with burnt gall; or,
dissolve acacia in vinegar, and anoint with it.
LXXX.— For Corns and Callow Flesh.
Having first cleaned the corns, apply one of the septics, either
verdigris, red arsenic, the powder for fistulee, or the coUyrium fi»
fistulse instead of gum mixed with ammoniac. A com is a whit
circular body like de head of a nail, forming in all parts of tl
body, but more especially on the soles of the feet and toes. It m
be removed in time by paring away the prominent part of t
com constantly with a scalpel, or rubbing it down with pomi
The same thing may be done to callous flesh. The ashes of nm
lupines burnt, and mixed with honey, are of use ; or, misy addv
liquid pitch ; or, gith, with the urine of a boy not come to pnbe
or, bean-meal boiled with vinegar. And this is an applicatic
approved efficacy for the same purpose : — Of cantharides, of
BOOK TH1BJ>. 363
peitui» of castor, equal parts ; mix with turpentine until it become
of the consistence of a plaster, and apply to the com previously
cleaned all around. Another : — Of burnt leeb of wine, of quick-
lime, of midetoe, equal parts, with strained lye ; or, the urine of a
boy not come to puberty.
LXXXI. — On Campkdnts about the Nails*, and, first, qf
Whitlow:
Whitlow is an abscess forming about the root of the nail.
When, therefore, the whitlow is small and but commencing, galls with
honey repress it, and prevent the formation of an abscess ; or, the
trochisk of Mnsa, or the Nere, in water. When a preternatural growth
of flesh has taken place, the object is to consume and break it with
things that are not of a corrosive nature. The sordes of the ears
and lycium are also good for whitlows. When it suppurates, hav-
ing opened it and evacuated the fluid, soak a sponge in water,
and apply ; or, apply a cataplasm of lentils pounded with water ; or,
palm plaster with wine ; or, green or dried roses macerated in water,
and pounded ; or, dried barley-flour with water. The flour of lu-
pines mized with honey or wine and honey is good for whitlow.
For ulcerated whitlows : — Of verdigris, of litharge, of each, dr.
iv. ; of sareocoUa, dr. iv. ; sprinkle of it what is sufficient, and ap*
ply externally a tent and sponge out of wine. And the flesh must
be separated from the ncdl all around.
On Ptbrtoia. — ^Pterygium is fungous flesh covering part of
the nail, being caused by whitlow or fiie like ; for which, sprinkle
equal parts of arsenic and manna, and apply a tent out of wine and a
sponge above it. Another : — Of chalcitis, of the flakes of copper,
of pomegranate rind, equal parts ; add to a roasted fig and honey,
first bathing the part with the decoction of the thickening matters
put into ointments ; and clean away the dried part of the ptery-
gium.
ForPtertgia op the Toss in a Putrid State, and for Ulcers
OF THE Pudendum. — Of frankincense, dr. i. ; of the scales of cop-
per, dr. i. ; of verdigris called ayston, dr. iv. ; of honey, one
cyathus : triturate in the sun imtil it become yellowish, and use
upon a splenium or bolster, having first bathed with wine.
A Composition for quickly Drying and Curing Pterygia. —
Of burnt sori, dr. ii. ; of frankincense, dr. ii. ; of verdigris called
wyston, dr. i. : having triturated with honey, apply to the pterygia.
It is useful for the other malignant ulcers, lividity, and putridity of
these parts. Another : — ^Add the flakes of copper to the flesh of
dates, or of figs, and use. Another : — Having boiled and triturated
pigeons' dung in must with fine polenta, apply warm. And the
flsJces sprinkled by themselves dry up pterygia. We must always
raise and remove with a scalpel the comer of the nail when it in>
creases so as to hurt the pterygium.
364 PAULUS iEOINBTA.
For Bruised Nails : — Apply a cataplasm of myrtle and the ten-
der leaves of pomegranate.
For Bloody Nails : — Mix fine flour with pitch, and apply.
To Rbmovs Disbasbd Nails : — ^Add triturated sulphur to axunge,
and apply.
How TO Remove Leprous Nails : — Of misletoe of the oak, of
red arsenic, of fenugreek, of each, oz. ii. ; of cantharides, of deadly
carrot, of each, oz. i. ; of vinegar, q, s. Another : — Of bee glue, of
Attic wax, of bitumen, of each, dr. ii. ; of native sulphur, dr. i.
Let only so much oil be added that it may not stain. In using it,
warm and apply it to the nails. Another : — Of liquid pitch, of wax,
of colophonian rosin, of turpentine, of ammoniac perfume, of native
sulphur, of aphronitrum, equal parts ; evaporate until it does not
stain. Another, from the Works of Ruffus, for leprous nails : — Of
cantharides, of native sulphur, of copperas, of each, oz. ss. ; of
liquid pitch, oz. ii. : having made into a plaster, apply to the nail,
removing it every third day.
Another for Removing Leprous Nails without Ulcera-
tion.— Of bitumen, of arsenic, of red arsenic, of native sulphur,
of each, dr. iv. ; add to rosin and use, removing it every seven
days. Another : — ^Mixing the flour of bitter vetches with sheep's
gall, or sheep's urine, use ; or, unslacked lime with oil ; or, Chian
mastich with opobalsam. Or, mixing copperas and native sul-
phur with misletoe, apply, by spreading what is sufficient on a
skin. Or, triturate stavesacre witii vinegar, and use. Or, of tur-
pentine rosin, dr. i. ; of red arsenic, double the quantity ; apply to
the root of the nail, and bind carefully. When the nail falls off.
apply the myrtle cerate, containing a small quantity of the compo-
sition horn rosin.
COMMENTARY
ON THE
THIRD BOOK
OF
PAULUS ^GINETA.
I. AM ALOPECIA AND OPHIASIS.
See Galenus,(/e Med, sec. Loc. lib. i., Parat Fact/, and Meih. Med. x\w, 18.
— Celsus, vi. 4. — Aetius, vi. 65. — Alexander, i. 1 . — Plinius, H. N. xxviii. 46.
— Octavius Horatianus, i. 7. — Marcellus,</e Med, — Isidorus, Orig, iv. 8. —
Oribasius, Sj^nop, viii. 22, and Meth. Med. iv. 5. — Nonnus, c. 8. — Heliodorus
ap. Nketam, — Incerti auctoris Frag, ap, MoschUmem in Gynac, p. 21. — Pol-
lux, Onomasticon, — Myrepsus, §. 38. — Actuarius, Meth, Med. ii. 5. — Psellus,
op. Med. — Serapion, i. 1. — Mesne, lib. ii. serm. 1. — Avicenna, lib. iv. fen. 7.
tr. 1. — Avenzoar, lib. i. tr. 1. c. 3. — Haly Abbas, Theor. viii. 8., Tract, iv.
12. — Alsaharavius, Pract. i. 2. — Rhases, ad Mansor. vi. 1., Contineru, lib.
xxxvi. — See also Cailimachus, Hj/mn. ad Dianamy \. 79, with the learned
Notes of Tytler and Spanheim.
Our author copies closely from Galen, who explains at considerable length
his principles of treatment, which consists of purging with warm cathartics,
shaving the part frequently, rubbing it, and using caleiacient applications.
He says that the disease is occasioned either by the deficiency or depravity
of the nutritive juices. Drs. Willan and Bateman describe this complaint by
the name of Forrigo decalvans. Bateman justly remarks, that, ''all that
can be prescribed respecting the treatment of this affection has been ex-
pressed by Celsus with his usual terseness : — ' Quidam hsc genera areanim
scalpello exasperant; quidam illinunt adui*entia ex oleo, maxim^que char-
tam combustam; quidam resinam tei-ebinthinam cum thapsia inducunt.
Sed nihil melius est quam novacul^ quotidie radere, quia, cum paulatim
summa pellicula excisa est, adaperiuntur pilorum radiculse. Neque ante
oportet desistere, quam frequentem pilum nasci apparuerit. Id autem quod
subinde raditur, illini atramento sutorio satis est.' '*
The modes of treatment recommended by the other authorities are in
principle the same as our author's and that of Celsus. Octavius Horatianus,
after directing to give pills containing colocynth, aloes, scam mony, and worm-
wood, recommends nearly the same external treatment as Celsus: — "Omnes
confectiones quae mediocriter calefacere possunt, mediocribus et delicatio-
366 COMMENTARY ON TUB THIRD BOOK.
ribus corporibus adhibendae sunt. Prius ergo loca linteolo usque ad ru-
borem ante curam confricentur mediocriter, ne vulnerentur. Quae si vul-
nerabuntur, oleo roseo, vel adipibus anserinis recuranda sunt.''
Dioscorides recommends tar-water and other preparations of pitch for
Alopecia.
In a Fragment of an anonymous author, published along with Moschion
in the Gynsecia, very sensible rules of treatment are given ; namely, to shave
the part frequently ; to rub it with compositions containing mustard, adarce,
wormwood, alcyonium, &c. ; and to purge with aloes, scammony, colocynth,
and the like. Similar directions are given by Heliodorus. Even Alexander,
who, in general, controverts freely the opinions of Galen, does not differ from
him at all in this case ; and Aetius and Oribasius are his servile copyists.
Marcellus gives a long list of compound medicines for the cure of Alopecia.
Pliny recommends bulfs gall with Egyptian nitre. The ancients were in
the practice of using nitre for cleaning linen, as is remarked by Bernard
(ap. Nonnum, u. s.) On the ancient practice of scrubbing the head with
nitre or soda — see Salmasius, ap, TertulL de Pallio, 432.
The Pseudo-Dioscondes recommends shaving, rubbing with nitre, and
stimulant applications containing arsenic. — Euporist.
The Arabians treat the disease exactly as the Greeks. Avenzoar recom
mends purging, a regulated diet, and friction with oil of nuts and cherva.
Haly Abbas approves of general evacuants, friction, and stimulant applica-
tions containing cantharides, nitre, &c. Alsaharavius recommends emetics
after food, purging with hiera picra, friction with compositions containing
mustard, euphorbium, pellitory, nettle-seed, with oil of sesame, or with liquid
pitch. Ophiasis, he says, is to be treated upon the same principles. Among
the ingredients of Metue's compositions, I remark cantharides, musk, and
amber. Serapion, like Galen and some of the others, makes mention of red
arsenic as an ingredient in these applications. Bliases, in his CoiUinenSf
collects the opinions of all preceding authorities on the nature and treat-
ment of these diseases. Most of tlie local applications recommended by
them are stimulants and i*ubefacients, such as mastich, eu])horbium, cantha-
rides, ladanum, St. JohnVwort, £rc. which are to be rubbed in with oil or
pitch. He mentions that the celebrated Antyllus recommended scarifications,
cupping, and leeching. Servitor directs to prepare a depilatory, by mixing
two parts of quicklime with one of arsenic in a crucible or mortar, and add-
ing a little water to them.
For the cure of Ophiasis, the earlier modern surgeons recommend depila-
tories containing arsenic, quicklime, vitriol, hellebore, and the like. One
described by Rolandus consists of quicklime and arsenic boiled in water.
— Lib. i. c. 14. A similar one is described by Plempius.
11. COMPOSITIONS FOR DTXINO THB HAIR.
Galen, when about to treat of compositions for the hair, remarks that the
application of these does not belong properly to the Physician, but that be
may sometimes be obliged to furnish them to Hoyul Ladiet, whom, under
certain circumstances, he cannot venture to disobey. That the Ladies, in
ancient times, were in the practice of painting their hair, is evident from
Achilles Tatius, ii. 149, and Juvenal, vi. 354. Eustathius mentions that
antimony was very much used for painting the eye-brows black. — Commtnt.
in Iliadf viii. versus finem.
For further information upon this subject, with which I must confess my-
self wholly unacquainted, I refer the reader to the following works:—
Alexander, i. 3. — Oribasius, iv. 7 and 8. — Aetius, vi. 58. — Nonnus, c. 2
COMMBNTART ON THB THIRD BOOK. 367
and 3. — Octavius Iloratianus, i. 1. — Avicenna, lib. iw, fen. 7. tr. 1. — ^Alsa-
bara?iu8y Pract. xvii. T.'-^Rhases, ad Maruor, lib. v. and Continent^ lib.
xxxvi. — Vegetius, the great authority on Veterinary Sargery, giret prescrip-
tions for dyeing the hair of cattle.— Jutf /am. lib. ti.
A great many prescriptions for dyeing the Hair may also be seen in tiM
Ninth Book of Baptista Portals Magia NaturaUs, Vander Linden gites
the following list of writers upon Cosmetics :— Amaldus de Villa Nofv,
Criton, Fallopius, Rondeletius, Kraut, Vangnana, Mercurialis, Besaidn^
Minadttus, Stephanus, Timara, Nicolus, Forestus, Laurenbergius, Uafenie-
ferus, Trotula.^ — De Script, Med,
The Thapsus mentioned in this chapter occurs in Theocritus, IdyL i. and
is said by the Scholiast to be a Scythian wood used for dyeing the hair. It
also occurs in Nicander, Tker. 1. 529. His metaphrasist, Eutecnius, says
that it grows in Sicily. Lucan, in like manner, calls it Erycina Thapsus, i. e.
Sicilian Thapsus. — Pharsal, ix. 916. It is impossible to determine exactly
what tree it was.
The opinions of the Philosophers regarding the hair may be learned from
Aristotle, H. A, iii. and Pliny, H, N, xi. 94. Both state that the hair and
also the nails grow af^er death ; and Philoponus mentions this circumstance
as a welUknown fact. See Comment, in Aristot. de Aninia, Preefat. It may
be proper to mention that Bichat and other modem Physiologists are of the
same opinion.
III. — ON PITTRIA8T8 AND OTHBR CUTANB008 DI8BA8XB.
Drs. WiLLAN and Bateman agree with all the best medical writers of an^
tiquity in describing, by the name of Pityriasis, a disease consistiug of
slight, scaly, and branny exfoliations without ulceration. — See Oalenus, Sec,
Loc, lib. i. — Alexander, i. 3. — Oribasius, Syn, vi. 25. — Aetius, vi, 66.— Ao*
tuarius, de sig, Morb. ii. 5. — Nonnus, c. 4.
It is the Parrigo sicca of Celsus (vi. 2.) who recommends to treat it by
shaving the head, and using slightly repressing applications, '^ quale est ni«
tmra euro aceto, vel ladanum cum myrteo et vino, vel myrobalanum cum
vino.*' Marcellos distinguishes the Pityriasis from Porrigo. — De Med.c. 4,
The Arabians, especially Serapion, direct very active general treatmeni!,
such as venesection, masticatories, cathartics, and the like, i. 4. It is de-
scribed under the name of Pwrfares Capitis by the translator of Ualy Abbas.
Theories, viii. 18. Like the Greeks, he represents it as consisting of smalt
furfuraceoos scales without ulceration. Alsaharavius uses the same name,
and recommends bleeding, cupping, purging, and external applications of a
detergent nature, such as flour of vetches, with vinegar and the like. Aven-
zoar recommends pills of drastic purgatives, and the ordinary lotions. Lib. i.
tr. 1. c. 10 See also Avicenna, lib. iv. fen. 7. tr. 1. c. 24 ; and Rhases, ad
Mansor. v. 1.— ContinenSj lib. xxxvi. In the Continens, the disease is de-
scribed by the names of Furfures and Impetigo, for which Rhases recom-
mends Liniments containing nitre, sulphur, hellebore, vinegar, &c.
Willan and Bateman describe the Psytiracia as being small pustules irregu^
larly circumscribed and terminating in a laminated scab. Most of the above-
mentioned writers treat of them in the same terms as our author. They
seem to be the Balchie of Avicenna, lib. iv. fen. 7. tr. 6. c. 1. who calls them
a malignant species of Achor. See Galen, u. s,
Galen, Alexander, Aetius, and our author, describe the Exanthemata as
being small superficial ulcerations. Drs. Willan and Bateman use it as a^neric
term for Hashes. The Exanthemata seem to be Uie Alraba or PustuUe dukes
of Alsaharavius, tr. i. 10. — See Book I. c. 6 ; and Book IV. c.8. of this Work.
368 •COMMENTARY ON THE THIRD BOOK.
Willan and Bateman apply the terms Arhor and FavUt in the same sense
as Paulus and the other ancient authors. Octavius Horatianus uses the terms
Accra and Cerio. He says, ^'Acorse et Ceriones distant, quod Ceriones
plures cavemas egestionis habent et humorem multo pinguiorem emittunt ;
Accra autem unam cavemam habet, et humorem egerit aquatiorem.*' Lib.
i. 5. Galen has treated of these complaints rery fullv, and bis applications
are similar to those of our author. See also most of the authorities on Pity-
riasis. The Favus is the first species of Tinea described by Ualy Abbas. It
consists, he says, of cells, and discharges a fluid like honey. The Achor is his
Amada, or third species of Tinea^ consisting of smaller cells than the former.
Ahaharavius describes the Favus by the name of Altahara, It contains,
he says, a viscid fluid like honey. He recommends for it purgatives, and
detergent applications containing nitre, lees of wine, &c. — Pract, i. 9. The
Achor is called AUahafa by him.
According to Mangetus, the Achcres of the ancients is the Crusia Lactea.
Bih. Chir,
The other authorities give the same account of Ficus as PaulusV It is
Haly Abbas' second species of Tinea, and is described by him as consisting
of hard round protuberances. Haly's fourth species of Tinea consists of
small ulcers ot a mammiform appearance. Tliey are mentioned by our
author. Fabrice d*Aquapendente deiines the Ficus thus : ^ Tumeur qui est
rouge, ronde, quelque pen dure, et de laquelle (etant ulcer^e et press^e) sort
une matiere sanieuse, semblable aux grains de figues/' — CEuv. Chir. p. i.
1. 1. c. 13. He says that Hippocrates and Galen give a different account of
it from our author's ; but I can see very little difference between them. Most
of the ancient authors recommend the same remedies for Ficus as Paulus.
The most active of these are stavesacre, and sandarach or red sulphuret of
arsenic. They do not appear to have apprehended danger from the free use
of arsenic in this way. Galen recommends equal parts of white hellebore,
stavesacre, and nitre with oil. De Med. Sec. Ij)c. lib. i. Octavius Horatianus
mentions equal parts of pellitory and galls. The same medicines are recom-
mended by Serapion, i. 5. — See also Oribasius, de hoc. Affect., iv. It. —
Celsus, xi. 3. — Ceelius Aurelianus, de Morh. Tardy iv. 2. Haly's remedies
consist of galls, litharge, mercury killed (sublimed ?), sulphur, and so forth.
Among those of Rhases I remark squills, assafeetida, quicklime, mercury, &c.
However, he prefers excision. Continem, xxxvi.
For Pediculi in the head, the Arabians recommend nearly the same com-
positions as our author. They contain arsenic, stavesacre, hellebore, nitre,
and the like. — See Alsaharavius, Pract. i. 16, and Rhases, Cont. lib. xxxvi.
c. 6. Among the ingredients mentioned by the latter, I remark quicksilver,
sulphur, red arsenic, mustard, stavesacre, the oil of oleander, vinegar, &c.
These medicines form the ingredients in the compositions recommended by
modern writers on this complaint. V. Plempius de Morbis Pilorum, and
Amatus Lusitanus, Curat. 58. A mixture of stavesacre and the Indian berry
(Cocculus Indicus) is now frequently used for destroying vermin in chil-
dren's heads. Mercurial ointment readily kills the pediculi pubit.
IV. ON CEPHALALGIA, OR HEADACH.
By Cephalalgia, as Aretseus remarks, is to be understood an acute pain of
the head, and by Cephalsa a chronic one. Our author does little more
than abridge the contents of the Second Book of Galen's Work, de Med. sec.
Loc. where this subject is treated of with unrivalled precision. — See also
Aretseus, de Morh. Chron. i. 2. — Oribasius, de Loc. Affect, iv. 1 — Celsus,
iv. 2. — Caelius Aurelianus, de Morh. Chron. i. 1 . — Octavius Horatianus, ii.
COMMBNTARY ON THE THIRD BOOK. ' 369
4. — Alexander,!. 10. — Pseudo-Dioscorides, Euporisty i. 6. — Actuarius, Meth.
Med. vi. 2. — Aetius, vi. 40.— Nonnus, c. 10. — Serapion, ir. i. c. 6. — Avi-
<:eDDa, lib. iii. fen. 1. tr. 2. — Avenzoar, lib. i. tr. 3. — Mesue, de Mgrit,
Capitis^ lib. ii. fen. 1. — Haly Abbas, Theor. ix. 3, Pract. v. — Alsaharavius,
Pract. tr. i. sect. 2, c. 1 . — llhases, ad Mansor. ix. 1 ., Continen,% i. tr. 21 .
In headach from heat, Galen and Alexander concur in condemning the use
of poppies and mandragora, unless when we are compelled to have recourse
4o them by the continued watchfulness of the patient. Galen directs to ap-
ply snow to the head. Avenzoar recommends the affusion of cold liquids
Irom a height upon the head. Serapion mentions oil cooled with ice. When
the pain is obstinate, Rhases approves of opening the temporal artery. When
the pain is violent, the author of the Euporiston recommends to shave the
head and bathe it with a decoction of narcotic vegetables.
For beadachs arising from a hot or cold intemperament, Galen recom-
mends the remedies called Metasyncritica by the Methodists, for an account
-of which see Le Clerc, Hist, de la Med. p. ii. Liv. iv. § 1. c. 3. lie says —
** Ce que Thessalus appelloit metasyncrise etoit un changement qu' il
pretendoit faire dans tout le corps, ou dans quelque partie seulement.'' Such
rubefacients as mustard, thapsia, &c. belonged to this class. — See also
Prosper Alpinus, de Med. Method, iii. 15. The term signifies " altering the
system ;*' and, therefore, I have generally rendered it " alteratives" in the
course of my translation.
Our author borrows his treatment of bilious headach from Galen and
Alexander. To his judicious account of headach from wine or a blow,
nothing need be added from any other author. Alexander justly remarks,
that, when it arises from the latter cause, it is very dangerous.
The Arabians generally treat of the disease by the name of Soda.
Headach, says Haly Abbas, is either seated in the head, or arises from
sympathy. When seated in the head, it either arises from an intempera-
ment, or organic disease, or flatus, or a blow. One of the most common
causes of sympathetic headach is the presence of bilious matters in the
stomach, which case is generally relieved by vomiting. Protracted watchful-
ness induces headach, by occasioning a corruption of the food in the stomach ;
and protracted sleep in like manner fills the brain with vapours. Excessive
evacuation, by producing a dry intemperament, proves a cause of headach.
It is in this manner that epistaxis and menorrhagia occasion headach. Haly
Abbas, like Galen, mentions as a cause of headach an excessive sensibility
of the nerves which connect the brain and stomach. Haly further states
that headach will arise from sympathy with the uterus, as after abortions,
obstructions of the lochial or menstrual discharge, and the like causes. He
remarks that violent headach will sometimes occasion loss of speech, owing
to an affection of the nerve which is distributed upon the muscles of speech .
His treatment, like our author's, is varied according to the nature of the ex-
citing causes ; and his account of it is so full and judicious, that I regret my
limits do not permit me to give a more ample detail of it. His remedies
are, general bleeding, cupping the extremities or back part of the neck,
anodyne or cold applications to the head, drastic or gentle purgatives, and so
forth.
Alsaharavius treats the complaint upon similar principles. When it arises
from heat, he recommends the affusion of tepid water over the head, and af-
terwards applies oils cooled in snow. When connected with bile, he directs
to open the belly. When it is occasioned by a sanguineous plethora, he re-
commends general bleeding and the application of cupping-instruments to
Ahe nape of the neck.
Rha.ses, as usual, treats fully of Soda and all its varieties. When of an
Bb
870 COXIIBNTAKT ON THB THIMD BOOK.
inflammatory nature, he recommends bleeding, purging, and the application
of vinegar and rose-oil to the head. When connected with bile, ne directs
Arst to vomit by drinking tepid water, and then to take porgatives, and after-
wards wormwood. When the disease is protracted, he approves of opening
the Temporal vessels, and of using sternutatories. When it arises from a
blow, he recommends bleeding, and purging with colocynth. Sec. He states
that RttfiVis recommended the affusion of cold water, or of oils congealed in
snow, over the head. In obstinate cases, he directs to use the Actual
Cautery.
V. ON CEPHALJEA.
Our author's account of Cephalsa is mostly abridged from Galen, sec. loc.
lib. iii. where the treatment is detailed at considerable length. Alexander,
Aetius, Oribasius, and the Arabians, follow the views of Galen ; and, as they
are similar to our author's, we need not dwell upon the exposition of them.
General and topical bleeding, cooling or stimulant applications to the head,
purgatives, masticatories, and errhines, applied according to circumstances,
constitute the sum of their treatment. One rule laid down by Oribasius de-
serves attention ; when the pain is acute, he recommends general bleeding ;
and, when it is protracted, local.
Aretseus, who probably was prior to Galen, delivers an admirable account
both of the symptoms and treatment of this complaint. He recommends
bleeding at the arm, and by opening the temporal arteries, or those behind
the ears, or cupping the back part of the head ; purging with drastic cathar-
tics; errhines, masticatories, a restricted diet ; and, in obstinate cases, he ap-
proves of applying the Actual Cautery to the cranium. — De Curat, Morb.
Ckron. c. i. Most of the ancient authorities recommend the Cautery in this
case. — See the Notes on Chap. I. of the Sixth Book. Aretseus allows a small
quantity of a light wine on account of the stomach, which is apt to be af-
fected.— Ibid,
Cslius Aurelianus has given a most minute account of the doctrines of the
Methodists respecting Cephalaa. — Ve Morb. Tar, i. 1. He enumerates
many causes of the disease, among which I may mention too much attention
mid to the hair by females. The following is an outline of his practice : —
Friction ofthe extremities, emollient fomentations and soft applications to the
head, such as wool, or bladders half filled with warm oil, are to be used at
the commencement. When the pain is violent, he recommends venesection
from the arm opposite the side affected. The head is to be shaven with a
razor, and a cataplasm, or a cupping-instrument without scarificators, or
leeches, are to be applied ; and these are to be followed by sponging with
hot water. If the belly be constipated, we are to give clysters of Uie oil of
rue with honey, or the like. In the decline of the complaint, emollient plas-
ters (malagmata) are to be applied. Gentle gestation before food is particu-
larly recommended, and walking afterwards. He directs to avoid exposure
to heat, indigestion, strong drink, hot baths, violent passions, constipation of
the belly, and so forth. Ilis directions respecting diet are extremely minute,
but judicious. With regard to topical applications, he recommends after tbe
head 'is shaven mild ones at first, and afterwards rubefacients and stimulants,
and cupping with much heat. Masticatories and gargles are mentioned. He
recommends affusion of water, at first hot and afterwards cold. When the
disease does not yield to these remedies, he directs to make trial of a course
of hellebore. The Methodist oppugns freely the practice of the other seeti.
Refrigerant applications, containing vinegar, rose-oil, and the like, he says,
COMMBNTART ON THE THIRD BOOK. 371
are very prejudicial; purgatives injure the stomach; cauteries excite a dan-
gerous disturbance ; the cold bath produces rigidity of the nerves ; and hot
masticatories do not answer well.
Rhases insists with becoming earnestness on the propriety of administering
purgatives, especially cholagogues, in Cephalaea. His commentator, Leonarr
dus Jacchinus, blames modern physicians for having substituted weak and
ineffectual cathartics for the powerful medicines of this class used by the
ancients. I may mention in this place that Dr. Abercrombie strongly com-
mends drastic purgatives, especially Crotan oil, in cases of protracted head-
ach. I have generally used elaterium, either alone or with calomel, for this
purpose.
Galen states correctly that Cephalsea often arises from disease of the peri-
cranium.— De Loc. Affect, u, t.
VI. — ON FHRBN8T.
Hippocrates treats cursorily of Phrenitis in several of his works, particu-
larly de Morh. iij. 9. See Galenus, Metk. Med. xiii.; de Loc. Affect, v. 4.
— Aretaeus, de Morh. Acut. i. 1. — Alexander, i. 13. — Aetius, vi. 2. — Actuar
rius, Metk, Med. iv. 2. — Nonnus, c. 25. — Pseudo-Dioscorides, Evporist. i.
13. — Cslius Aurelianus, Morb. Acut. i. 1. &c. — Celsus, iii. 18. — Serenus
Samonicus. — Octavius Uoratianus, ii. 2. — Serapion, i. 20. — Mesne, de Mgr.
Capit, c. 19. — Avenzoar, lib. i. tr. 4. c. 6. — Haly Abbas, Theor. ix. 4. and
Fract. V. 13^^-— Alsaharavius, Pract. tr. i. § 2. c. 8. — Rhases, ad Mamor. ix.
3. and Continent^ i. tr. 28.
Galen gives a very circumstantial detail of the symptoms, which is well
worth consulting. — Jjoc Affect, u. s. Our author^s descriptionis very com-
plete, considering its brevity. He closely follows Alexander, who agrees
with him in recommending the most questionable part of our author's treat*
ment, I mean the administration of wine. Of course, however, it must have
been a weak light wine. He insists that, when the strength is much reduced,
it does more good than hdrm, by improving the powers of the constitution.
Cflelius, however, says that wine is nothing less than a poison. Alexander,
Aretsus, and Aetius, agree that cold drink should be given with caution.
Most of the authorities have correctly described the ]>ulse as being smalt and
dense. Among the minutiae of practice, we may mention that Aretaeus and
>Celsus, like our author, recommend to remove all pictures and such like
gaudy objects from the s^artment of the sick. Celsus directs, in pointed
lerms, after bleeding and purging, to get the head shaven and fomented with
a decoction -of emollient herbs. To procure sleep, he recommends draughts
containing poppies and hyoscyamus ; or, to apply the apples of the man-
^ragora below the pillow of the patient ; or, to rub his forehead with anK>-
mum, or the tears of mulberry. He informs us, however, that Asclepiades
condemned soporifics as inducing lethai^y. For the sake of procuring sleep,
he approves of gestation performed at night, and of swinging the patient in a
suspended couch. For the same purpose, the Pseudo-Dioscorides recom-
mends to introduce the juice of poppies or mandragora upon wool into the
Rectum.
Caelius Aurelianus gives an admirable account of the symptoms and treat-
ment of this disease; and his views are, in this case, not very differeiM: from
those of Hippocrates and Galen. He informs us that Asclepiades con-
demned venesection, which, he said, was nothing less than murder; that he
disapproved of keeping the patients in a dark place ; and that he allowed
them plenty of strong wine. Both Caelius and Celsus properly animadveiet
B b 2
372 COMMBNTART ON THB THIRD BOOK.
upOD his treatment. Cslius also blames Diodes for admitting of venesec-
tion after the seventh day, and for approving of too acrid clysters. He finds
fault with Themison for allowing too much food and wine at the commence-
ment, and for using the bath indiscriminately. He condemns the practice of
Heraclides, because he applied the treatment of the Emperics injudiciously,
and admitted of bleeding from the Frontal vein, which, Caelius says, is most
prejudicial.
The treatment recommended by Octavius Horatianus is little different
from that of the others.
The Arabians call the disease Karabitus. The symptoms, according to
Haly, are, heat not much increased, but the head warmer than (he rest of the
body ; alienation of the mind ; watchfulness, but sometimes somnolency,
from which state the patient wakes with starting; blackness of the tongue;
picking at the bed-clothes; pulse in all cases weak, small, and hard. He is
very minute upon the treatment, recommending bleeding from the Cephalic
vein ad deliquium ; cupping ; gentle laxatives, such as prunes and tamarinds ;
vessels filled with cold water or snow applied to the head ; in certain
cases sinapisms to the feet; and, when watchfulness is protracted, applica-
tions to the head containing poppies, mandragora, lettuce, &c. Alsaharavius
particularly mentions general bleeding, bleeding from the Temporal vein or
the Angular vein of the nose, pouring decoctions of refrigerant herbs over
the head, and, when the insomnolency is obstinate, washing the temples with
infusions of hyoscyamus, poppies, lettuce, &c. Avenzoar speaks of opening
the artery in the head — an operation mentioned by Galen. Rhases directs
to pour vinegar and rose-oil from a height upon the head. His general re-
medies are similar to those of the others, namely, general and local bleeding,
with gentle laxatives, such as myrobalans, prunes, and tamarinds. S^rapion
and Avicenna direct much the same treatment as our author.
VII, ON PHLBOMON OP THB BRAIN.
This chapter is taken from Aetius, vi. 25. or Oribasius, Synop, viii. 11.
See also Avicenna, lib. iii. fen. i. tr. 3. c. 4. — Haly Abbas, Theor, ix. 4. and
Pract. V. 14. — Alsaharavius, Prnct. i. § 2. c. 9.
Modern pathologists will scarcely admit of such a case distinct from Phre-
nitis. However, in certain cases of Ramollissement de Cerveau, with hydro-
cephalic effusion, the symptoms are much the same as described by the
ancients. In children, I have often seen the bones separated at the sutures
by the collection of water.
The Arabians call it Massera, Phlegmon of the Brain, according to Haly
Abbas, is attended with swelling of the brain, so as to occasion a separation
at the sutures, redness of the face, acuteness of vision, and sympathetic ai^
fection of the stomach. He recommends bleeding at the arm, cooling laxa-
tives, applications of cold things to the head, and so forth. The translator
of Alsaharavius calls it Flegmon and Apostema in Cerebro ; says it is occa-
sioned by a collection of corrupted blood in the vessels of the brain ; and
directs general bleeding, opening of the Nasal vein, or of the Sublingual. —
Avicenna's account is nowise different from our autlior's.
Hippocrates makes mention of Sphacelus of the brain, which, he says, ge-
nerally proves fetal in three days. — Aphor. lib, vii.' From the Commentary
of Galen, it would appear that by Sphacelus he meant that state which is the
result of an extreme degree of Inflammation. It was, therefore, a species of
Ramollissement. In fact. Dr. Abercrombie^ considers Ramollissement as
analogous to Gangrene in other parts of the body.
COMMBNTART ON TBB THIRD BOOK. 373
VIII. ON BRTSIPBLAS OF THB BRAIN.
Aetius, Oribasius, Avicenna, Haly Abbas, and Alsaharavius, treat of this
disease in much the same terms as our author. Haly says there is less heat
of the face than in Phlegmon, nay, that the face even feels cold. Alsahara-
vius describes it as being accompanied with violent pain, much inflamma-
tion, and blackness of the face. He approves of the depletory treatment in
general.
IX. ON LBTUAROr.
See Hippocrates, de MorbU, lib. iii. 5. — Celsus, iii. 20. — Galenus, Meth.
Med. lib. xiii. — Oribasius, Sj/nop, viii. 1. — Aetius, vi. 3. — Alexander, i. 14.
— Actuarius, Meth. Med. iv. 2. — Nonnus, c.22. — Octavius Iloratianus, ii. 2.
— Cslius Aurelianus, de Morb. Acut. ii. 1. — Avicenna, lib. iii. fen. i. tr. 3.
c. 7. — Serapion, i. 17. — Mesne, de. Mgrit. Cap. c. 22. — Haly Abbas, Theor.
ix. 5. and Pract. v. 15. — Rhases, Divis. c. 6., ContinenSy lib. i.
Among the many pretended improvements with which the medical world
is every now and then amused, we may rank Dr. Cullen's discovery that Le-
thargy, Coma, Cams, and Catochus, are all merely varieties of Apoplexy.
Subsequent authors, however, have found it convenient to revert to ancient
opinions on these matters. See Cheyne on Apoplexy/.
The ancients, it will be remarked, ascribe the disease to serous congestion,
which is a very plausible theory. All the other autlioriiies recommend nearly
the same treatment as our author.
Aetius, as usual, is minute and judicious. He remarks, that purging is not
only useful, by producing evacuation of the bowels, but also by occasioning
revulsion. When the disease comes on after Phrensy, he forbids venesection,
but otherwise approves of it. He and Alexander strongly commend castor.
Alexander directs venesection, if the patient's strength permit ; the applica-
tion of vinegar and rose-oil to the head ; and, when the disease is on the
decline, applications containing castor and other such stimulants. It is to
be remarked, by the way, that Haly Abbas states this as the mode of treat-
ment directed by Alexander Aphrodisieus, from which it may be inferred
that A. Trallian and A. Aphrodisieus were the same person.
Celsus speaks favourably of the affusion of cold water. A case in point
is related by Van Swietan, Comment. § 1049.
The methodical treatment recommended by Caelius Aurelianus is not much
different from that of the other sects. He approves of bleeding, of shaving
the head, and applying cupping-instruments to it, or else leeches; of making
the patient lie in a bright light; of using gentle means to rouse him; but he
justly condemns Diodes for recommending measures of great severity, which,
he says, will do but increase the disorder of the brain. He also disapproves
of the practice of Praxagoras, who gave wine and hot stimulants ; and fur-
ther ridicules him for neglecting the head, and merely applying fomentations
to the feet. He does not approve of Asclepiades' practice of treating the
disease with strong sternutatories, sinapisms to the head, and analeptics. He
finds fault with Themison for making his patient lie in a dark place. He
also condemns Themison*s practice of giving aloes by the mouth before food,
as it will make the food in the stomach spoil, that is to say, will interrupt the
digestive process, or, in case of its not operating downwards, will be ab-
sorbed^ and increase the constitutional disorder. lie further disapproves of
Themison*s practice of carrying gestation to an inconsiderate length. He
likewise condemns the use of the cold bath, which had been recommended
374 COMMBNTA&T ON THB THIRD BOOK.
by Themison. He then gives an account, of the practice enjoined by Ile-
raclides Tarentinus, the Empiric, which, of course, he does not approve of;
although, judging of it from modern views, I do not think it particularly ob-
jectionable. I dare not enter upon the detail of it, owing to its length.
The Arabians generally treat of it by the name of Sirsen Frigidum. Like
the other authorities, Haly Abbas st£it6s the causes of the disease to be, a cold
and humid intempeiament of the brain, or a collection of pituitous humour*
As stated above, he quotes the practice of Alexander with approbation. He
particularly recommends acrid clysters, drastic purgatives, shaving the head,
applying stimulants to it, rubbing the feet, and, in certain cases, sternuta-
tories, Rhases does not mention venesection ; but Avicenna and most of
his countrymen do. Avicenna dnd Mesne recommend emetics. Their treat-
ment otherwise, like our author's, consists of acrid clysters, friction of the
extremities, masticatories, calefacient and repellent applications to the head.
With regard to the last, Mesue may be consulted with advantage. Rhases,
in his ContinenSf recommends bleeding, fetid pills, leeches, cupping, and
afterwards sternutatories, friction of the extremities, and so forth.
X. ON CA.T0CHU8.
Most of the authors referred to in the preceding chapter may be consulted
on Catochus, or Catalepsy. It is called by the Arabians Subet AUari. It is »
disease of rare occurrence, but cases of it have been related by modern
writers. (See Fernelius, Platerus, Dodanaeus, llenficus Regius, Heberden,
Hoffmannus, and the late writers on Animal Magnetism.) Nonnus and other
authorities remark that it is accompanied with Fever. Their general treat-
ment consists of venesection; clysters of the decoctions of rue and cumin,
with nitre and honey; epithemes applied to the belly; and fomentations of
water and oil to^the head. Haly says that the disease arises from a collec-
tion of phlegm on the brain ; from pressure in cases of fracture of the skull ;
or from the projection of the internal plate of the cranium. His treatment
is judiciously modified according to the nature of the exciting cause. He
approves of sinapisms to the head, friction of the feet, and so forth. Alsa^
haravius recommends venesection when the exciting cause is a Bilious 'hu-
mour, but forbids it when the disease arises from a collection of phlegm.
His treatment is judicious, but not much different from our author's. — Pract.
tr. i. § 2. c. 13. Rhases* general remedies are clysters, purgatives, restricted
diet, and, if indicated, bleeding at the arm or ancles.
Caelius Aurelianus describes the disease with his usual accuracy. He
says it occurs in cases of Continual, Intermittent, and Ephemeral Fevers.
The iiymptoms as detailed by him are, acute Fever ; loss of speech ; dul-
ness of the senses; pulse large, strong, and full ; and the eyes fixed. With
regard to his treatment, he says nothing of venesection, but approves of fb-
medtations to the head of sweet tepid oil ; and mentions common clysters,
cataplasms to the loins, in order to relieve the retention of urine ; shaving
the head, and applying cupping-instruments to it, scarifications along the
occiput, baths, fomentations of oil, &c. He disapproves of the practice of
Chrysippus and Themison, who recommended stimulant ointments to the
head, shaving the head, and applying sinapisms to it with sternutatories
and acrid clysters.
See an excellent account of Catalepsy in Van Swietan, Com, § 1036.
Like Caelius he mentions Intermittent and Continual Fevers among the ex-
citing causes of the disease. I have seen some cases of Common Fever
accompanied with Catalepsy. On the confusion about CatochUs and Coma
\'^i.c;il, see Prosper Alpinus, de Med. Meth. x. 6.
Henricus Regius relates an interesting case of Catalepsy, which was curexl
COMMSNTARY ON THS THIRD BOOK. 375
by drastic purgatives, sternutatories, friction of the extremities, and the ad-
ministration of the Theriac. — Animad. Med. c. 6.
Hoffman describes the Coma Vigil as an affection marked by a strong pro-
pensity to sleep, with an inability at the same time to fall asleep. He justly
remarks that it is altogether symptomatic, and occurs only in Ardent Fevers,
being generally the precursor of Phrenitis. — Oper. tom. iv. c. ii.
XI. ON CARU8, LOSS OF MXMORT, AND FATUITY.
S££ most of the authors on Lethargy and Catalepsy.
NoNMUS says that Carus resembles apoplexy, only that in the latter dis-
ease the posterior ventricle of the brain is more especially loaded with se-
rum, whereas in Carus the anterior is affected. It differs also, he says, from
lethargy, in this respect, that Fever precedes Carus, but is subsequent to an
attack of lethargy. Carus, he adds, is occasioned by a blow, pain of the
head, and fracture of the bone compressing the brain. Alexander also says
that, in Carus, the anterior part of the brain is most affected ; and hence
the Sensorial powers are much impaired. It is occasioned, he says, by vio-
lent pains which dissipate the vital spirits. On the cure of Loss of Memory,
see Galen, de Loc. Affect, iii. 5.
Avicenna has treated at great length of the subjects of this chapter. Among
other things, he recommends the celebrated Theriac, which contained a very
diffusible stimulant oil. His treatment otherwise resembles our author's.
The same may be said of Haly Abbas. For Loss of Memory, Alsaharavius
recommends to apply fragrant and stimulant oils to the head, along with ge-
neral treatment.
Cxiius Aurelianus and Octavius have not treated of Carus by name ; but,
according to Prosper Alpinus, the Methodists entertained similar opinions
of the disease to the other sects. — De Med. Meth. \. 5.
Sydenham gives a description of an Epidemical Fever, one of the most
striking symptoms of which was Carus, or a strong tendency to sleep. It is
known in Scotland by the popular name of " The Sleepy Fever." Van
Swietan describes it, like the ancients, as an inferior degree of apoplexy.
Procopius states that Carus was a common symptom of the fatal plague
which prevailed in the reign of Justinian.— -Perstc. lib. ii.
The philosophers, as well as the physicians, taught that Loss of Memory is
often connected with disease of the posterior portion of the brain. See, in
particular, the Commentary of Philoponus on Aristot. de Anima, lib. i.
XII. ON VERTIGO.
See Galenus, de Loc. Affect, iii. 12. — Aretaeus, Morb. Chron. i. 3. —
Aetius, vi. 7. — Oribasius, Synop. vi. 5. — Actuarius, Meth. Med. vi. 2. —
Nonnus, c. 35. — Caelius Aurelianus, Morb. Chron. i 2. — Octavius Hora-
tianus, lib. ii. p. 2. c. 3. — Serapion, i. 3. — Avicenna, lib. iii. fen. i. tr. 5.—
Mesue, ii. 13. — Haly Abbas, Theor. ix. 5. Pract. v, 20. — Alsaharavius,
Practf tr. i. § 2. c. 6, 7. — Rhases, Divis. 5., ContinenSf lib. i.
Galen agrees with Archigenes, that Vertigo may either be a primary affec-
tion of the brain, or may proceed from sympathy with the mouth of the sto-
mach. Archigenes pretended to distinguish between the two cases in the
manner described by our author, that is to say, when the disease is preceded
by noises in the head, stupor, loss of the sense of smell, or of any other sense,
he concluded that the disease was a primary affection of the brain ; whereas, if
376 COnifSNTART ON THB THIRD BOOK.
preceded by nausea and heart-burn, he believed that it had its origin in the
stomach.
Aretseus details the treatment with great minuteness. He recommends
restoring any suppressed secretion, bleeding at the arm, capping, opening
the frontal or nasal veins, sternutatories, emetics of hellebore and the like ;
cold applications to the head, friction of the extremities, gestation, walking,
restricted diet, the cold bath, but not the hot. Aetius, in an extract from
Posidonius, treats of the disease in much the same terms.
Ceelius Aurelianus recommends the same treatment as for Cephalsa, Oc-
tavius approves particularly of hellebore.
Serapion directs to open the arteries behind the ears, which practice, liow-
ever, Galen had pronounced to be less useful than some had represented. Mesue
makes mention of leeches to the no^e, and medicines for renewing the men-
strual and hcsmorrhoidal discharges when suppressed. Avicenna speaks of
the Actual Cautery (see Book VI. c. 1. of this work). Vertigo, according to
Ilaly Abbas, may arise from a pituitous or sanguineous Plethora of the Cere-
bral vessels, or from compression occasioned by fracture. He approves of
general and local bleeding only when there is a Plethora of blood. In other
cases he recommends drastic purgatives, aromatic stimulants, masticatories,
and sternutatories. His treatment is judiciously modified according to the
nature of the exciting cause. Alsaharavius recommends opening the arteries
behind the ears, strong purgatives, clysters, gargles, and hot plasters contain-
ing mustard, and the like. Aaron, one of Rhases' authorities, decidedly incul-
cates that Vertigo may either be connected with disease of the brain or of
the stomach. lie principally recommends bleeding and purging, and also
speaks favourably of cupping the nape of the neck.
XIII. — ON EPILEPSY.
Consult Hippocrates, de. Morbo Sacro. — Galenus, de Sympt. Diff c. 3.,
De Loc. Affect, iii. 11., De Vuero £pi/e/?^ifO.— Oribasius, Syn. viii. 3. —
Aetius, vi. 13. — Aretaeus, Morh. Acut. i. 5., Morb. Ckron. i. 4. — Pseudo-
Dioscorides, Euporist. i. 21. — Alexander, i. 15. — Actuarius, Meth. Med.i.
16. — Nonnus, c. 36. — Serenus Samonicus. — Scribonius Largus, c. 12. —
Apuleius, Apologia. — Celsus, iii. 23. — Octavius Iloratianus, ii. 2. — Isidorus,
Origines, iv. 8. — Plinius, H, N. xxv. 5. — Avicenna, lib. iii. fen. i. tr. 5, c. 9.
Serapion, i. 23. — Haly Abbas, Theor, ix. 6., Pract. v. 21. — Alsaharavius,
Pract. i. § 2, c. 36. — Avenzoar, lib. i. tr. 9. — Mesue, de Mgr, Cap. c. 26. —
Hhases, ])iv. c. 7, alibique.
Our author derives his principles of treatment, more especially with re-
spect to re;yimen and diet, from Galen's directions for the management of an
epileptic boy. Part seems also to be borrowed from Oribasius.
Hippocrates- with great good sense rebuts the popular belief of his own
times, that the Epileptic paroxysm is produced by demoniacal infkience.
He justly remarks, that the inferior animals, such as goats, are subject to
this complaint; and that in them it is found to be occasioned by water in the
brain. The dsBmoniacs mentioned in Scripture were most probably Epilep-
tics and Lunatics. (See Mead*s Medka Sacra.)
Celsus lays down his rules of treatment with his usual judgment and ele-
gance. His practice is very similar to our author's. He recommends
bleeding; purging with black or white hellebore; shaving the head and apply-
ing cupping-instruments to it, and, in desperate cases, even the Actual
Cautery ; also friction of the extremities, and bleeding in the foot, along with
attention to exercise and diet. The use of hellebore in Epilepsy is men-
tioned by Pliny, and by Aulus (rellius, Noct. Attic, xvii. 15.
COMMENTARY ON TBB THIRD BOOK. 377
The poet Lucretius give a very glowing aod accurate description of tlie
symptoms and causes of epilepsy. — Uc Rerum Natura, lib. iii. c. 485.
Aretsus delivers separately the treatment of an acute attack and of the
disease when in a chronic state. For the former he recommends the general
remedies (I mean bleeding, clysters, and emetics). Among the medicines
enumerated by him for the cure of Epilepsy, I remark that he mentions cop-
per, which, he says, when given with cardamon, will act either upwards or
downwards. I need scarcely say that copper has been strongly eulogised in
modem practice. In the treatment of chronic cases, he pays particular at-
tention to the head, opening the veins and arteries of it, boring the bone
down to the diploe, and applying the Actual Cautery to it. A more rational
and less dangerous procedure was the application of embrocations contain-
ing cantharides and other such rubefacients to the scalp, and this practice
deserves imitation. He speaks highly of the virtues of castor and the theriac.
With respect to diet, he prudently forbids every thing of a gross and heating
nature.
Aetius, Oribasius, Actuarius, and Alexander, treat the disease upon the
same principles as our author. Alexander, although otherwise a most judi-
cious and original writer, expresses great con6dence in the use of amulets.
He paiticularly approves of drastic purgatives and emetics.
Isidorus thus defines epilepsy : — '* Epilepsia vocabulum sumpsit quod
mentem apprehendens pariter etiam corpus possideat. Fit autem ex raelan-
cholico huraore quoties exuberaverit, et ad cerebrum adversus fuerit."
No ancient author has treated of epilepsy more accurately than the great
Methodist, Cxlius ; but his account is so long and minute, that it is impossible
for me to do justice to it in an abridgement. The causes of the complaint
which he enumerates are, drinking too much wine, indigestion, compression
of the brain, and frights. He says that the whole nervous system is affected,
but especially the part seated in the head. When the patient is an in tot,
he properly directs either to change the nurse, or to pay particular attention
to her diet. Blood-letting he approves of on a first attack, unless the sto-
mach be loaded with crudities ; and, if there be pain in any part of the head,
he directs to apply leeches to it. He recommends gargles, and rubbing the
skin with substances which occasion an eruption of pustules. He enjoins
great caution in the use of hellebore. He approves of gentle exercise, a light
diet, abstinence from wine, change of scene, or a sea-voyage. With respect to
the modes of treatment pursued by the other sects, he greatly disapproves of
the application of fire and other hot things to the head, and of strong sina-
pisms to the other parts of the body. Escharotics applied to the head, he says,
only increase the disorder ; and the use of bull's blood, or that of a man re-
cently killed, and other such ridiculous remedies, he properly treats with con-
tempt. He disapproves of diuretics, and of hellebore, scammony, and the like,
when administered indiscriminately. He speaks unfavourably of chalybeates.
The Arabians follow closely the views of their Grecian masters, without
suggesting any material improvement. Haly Abbas says that epilepsy is a
convulsion which either comes on periodically, or at no stated times ; and
that it either arises from the brain itself, or from sympathy with the stomach,
or with some other part of the body. It is occasioned, he says, either by a
gross humour collected in the ventricles of the brain, or from compression
produced by fracture. He makes mention of the epileptic aura, and, like our
author, states, that the disease is distinguished by foam at the patient's
mouth. He joins Hippocrates in pronouncing such cases as occur before
puberty to be not difficult to cure, but those which supervene afler that
age to be most intractable. When the complaint occurs in an infant, he
properly directs to attend both to the nurse's and the infant's diet. In cases
attended with plethora, he approves of general bleeding, cupping the limbs.
378 COMMANTAKT ON THE THIRD BOOK.
and opening the saphena. When the disease is protracted, he advises to ap-
ply cupping-instruments to the neck, and to give drastic purgatives, such
as black hellebore* colocynth, &c. When it appears to proceed from the
stomach he approves of emetics. He commends peony applied as an amu-
let. It is worthy of remark, that Andreas Laurentius, in the 17th century,,
speaks confidently of this remedy. So inveterate is the dominion of super-
stition and ignorance 1 Alsaharavius gives a curious account of epilepsy,
but mixed with some superstitious notions^ He says he had had ocular
proof that epileptics are possessed with demons ; for that he had known
many of them who had a knowledge of things which he was sure they had
never learned. Like the others, he speaks of amulets; but his general treats
roent is sufficiently rational and scientific.
Khases gives the theories and practice of preceding authors along with his
own remarks, which, however, contain no very original opiuions. One of
his Arabian authorities recommends bleeding at the arm, and also, by cup-
ping and opening the occipital arteries, rubbing the head with mustard,
purging with hiera, sternutatories, &c. The application of mustard to the
head is approved of by most of his authorities.
Like our author, most of the ancient writers approve of Cyrenaic juice^ or
assafoetida, in cases of epilepsy.
XIV. ON MBLANCHOLT, MANIA, AND POSSBSSBD PBR80NB, OR
DEMONIACS.
Consult Hippocrates, Aphor. — Galenus, Comment, in Aphor,, de Morh,
Vulg, — Celsus, iii. 18. — Aretsus, de Morb, Chron, ii. 16. — ^Aetius, vi. 8. —
Nonnus, c. 32. — Oribasius, Syn. viii. 17. — Alexander, i. 16. — Actuarius, de
Dig. Morh. ii. 34. — Octavius Horatianus, lib. ii. p. 2. c. 5. — Mesne, de Mgr.
cap. 34. — Serapion, tr. i. c. 22. — Avicenna, lib. iii. fen, 1. tr. 4. — Avensoar,
lib. i. tr. 9. c. 16. — Haly Abbas, Theor. ix. 7., Pract. v. 23. — Alsaharavius,
Pract. lib. i. § 2. c. 27. — Hhases, ad Mansor. ix. 13., Continens, lib. i.
Hippocrates in his Aphorisms points out the lower intestines as the seat
of melancholy, and directs to cure the complaint by purging. Galen in his
Commentary agrees with his principles and practice. Galen states cor-
rectly, that melancholy sometimes changes to epilepsy, and, versa vice, that
epilepsy is ofleu succeeded by melancholy. — De Loc. Affect, iii, 10. He
gives a curious extract from the Works of Diodes, with remarks upon the
same.
Aretffius considers melancholy as an incipient mania. He gives a masterly
sketch of the different modes in which mania makes its attack, and relates
an interesting case of a joiner, who was perfectly sound while engaged at his
work, but no sooner lef\ the place where he was occupied than he became
mad. For the cure of melancholy, he advises to abstract blood at the com-
mencement, according to the patient's strength and condition. He approves
then of giving black hellebore, and of applying cupping-instruments over the
liver, stomach, or to the head, according as these may happen to be affected.
He recommends then to give wormwood and aloes. When the menstrual
or hsemorrhoidal discharges are stopt, they are, if possible, to be restored ;
and, for this purpose, blood may be abstracted from the ancle, or even from
the arm. He also approves very much of the natural hot baths.
Celsus, in cases of melancholy and mania, recommends in particular
vomiting and purging by hellebore ; with the l)lack species, if the patient is
affected with grief; but with the white, if with gladness. He also approves
of bleeding.
Aetius gives an interesting account of the treatment of melancholy, prin-
COXMBNTART ON THE THIRD BOOK. 379
cipally extracted from the works of Galen, Ruffus, Posidonius, Archigenes,
aad Justus. The remedies which all of them seem to have reposed most
coDfidence iu, are drastic purgatives combined with bitters and carminatives.
They approve, however, of general bleeding and cupping, when indicated by
the symptoms of the complaint, and the state of the patient. Nonnus in
like manner prescribes bleeding in the forehead, purging with hiera picra,
acrid clysters, and bitters, such as gentian and staechas.
Alexander's plan of treatment is very circumstantially detailed ; but it
differs very little from our author's, except that he recommends Armenian
bole instead of white hellebore. Like AretSBUs, he strongly commends the
use of the hot bath for the cure of melancholy. Instead of hellebore, Sera-
pion and Avicenna particularly praise the lapis lazuli* Haly Abbas gives
a graphic delineation of the bizarre fancies, absurd fears, hopes, and vain
imaginations of melancholies and maniacs. Like the other authorities, he
attributes the disease to the prevalence of black bile. Without doubt, as I
have often remarked, the alvine discharges in such cases are dark-coloured ;
and this, no doubt, gave rise to the ancient opinion that the disease origi-
nates in black bile. When the patient is young and of a hot temperament,
lialy permits to abstract blood from the arm or temples* He approves
particularly of hot drastic purgatives, such as black hellebore, scammony ,
agaric, and the like. He also directs to give poppies, lettuces, &c to com-
pose the patient. He recommends Cholagogues, such as the decoction of
wormwood, and the like. But his treatment is too minutely and circum-
stantially detailed to admit of being done justice to within my narrow limiUi.
The same may be said of the account given by Alsaharavius. Rhases in
certain cases approves of venesection for the cure of melancholy. When
connected with dyspepsia, he recommends emetics and purgatives, especially
black hellebore. He also approves of the tepid bath.
We must now mention the opinions of the Methodists* In cases of melan-^
choly, Caelius Aurelianus disapproves of aloes and wormwood, as acting too
violently ; and also forbids venesection and purging with hellebore. On
the contrary, he recommends astringent articles of food, and astringent ap-
plications containing galls, alum, hypocistis, &c* to be laid over the stomach.
Of mania he gives a fuller account, replete with much valuable matter that
does not readily admit of abridgement. He enumerates many exciting causes
of the complaint, such as intoxication, inordinate passions, indigestion, ex-
posure to the sun, suppression of the hemorrhoidal and menstrual discharges,
and the like* Maniacal persons, he says, are differently affected, one be-
lieving himself a cock, another a tile, another a god, another an orator, and
such like ridiculous fancies. He then inculcates the important feet, that the
affection of the mind id always secondary, and not primary, as some had sup*-
posed. His moral and medical treatment is of the most emollient kind ;
and he enjoins retirement and quietude. When the patient's strength will
permit, he approves of venesection, the application oi cupping-instruments
to the head, and leeches to any other parts of the body which may be particu-
larly affected. He commends strongly the bath of oil and the natural hot-
baths. He also approves of hellebore. He condemns the practice of the
other sects in many respects. He does not approve of abstracting blood
from both arms, so as to produce deliquium, nor of keeping the patient con-
stantly in a dark place, nor of opening the temporal artery. He disapproves
of applying narcotic fomentations to the head. He properly forbids all
corporal punishment, although he approves of contradicting the whims of
the tnaniac, and of reasoning him into a better train of thought.
Isidorus thus distinguishes epilepsy, melancholy, and mania : — " Epilepsia
autem in phsntasia fit, melancholia in ratione, mania in metnoria.''
The use of hellebore in mania and melancholy is often alluded to in the
380 COMMENTARY ON THE THIRD BOOK.
works of the Latin Classics. — See, in particular, Hoi-atius, Sat. lib. ii. s. 3. —
Persius, Sat, iv. 1. 16. I am inclined to think that it was the black helle-
bore which was given in Anticyra. — See Dioscorides, iv. 146.
Dr. Mead recommends black hellebore for the cure of melancholy and
mania.— Mo/ii^. et Prac, He concludes, with a great degree of proba*
bility, that the daemoniacs mentioned in Scripture were persons affected
with epilepsy and mania. — Med, Sacr* The same opinion is adopted by the
learned Simeon Lindinger. — De Damone et Danioniacis, c. 16*
Cicero makes some pertinent remarks on the distinction between mania
and melancholy* — Tusc. Disp* iii. 5.
Prosper Alpinus and Hofiman agree with the ancient authorities in strongly
recommending the tepid bath for the cure of melancholy. This practice in
such cases is now too little attended to.
XV. — ON INCUBUS, OR NIGHT-MARE.
See Aetius, vi. 12. — Oribasius, Syn. viii. 2. — Actuarius, i. 16.— Caelius
Aurelianus, Tard, Pass, u 3. — Psellus, Opus Medicum, — Avicenna, lib. iii.
fen. 1. tr. 5. c 7. — Alsaharavius, Pract, i. 33. — Rhases, ad Mansor. ix. 12.,
Continens. lib. i.
The other ancient authors treat the complaint, like our author, by evacuants.
Bleeding (Rhases recommends this to be done at the ancle), di*astic purga-
tives, and friction of the extremities, are the common remedies. Alsaharavius
says that, if not cured by bleeding, it is to be treated as epilepsy, with hiera
and the like. Even Cselius in this case nearly agrees with the others, re-
commending restricted diet, and, if the disorder is great, venesection. He
also approves of applying cupping- instruments with scarifications on the side
of the throat, and, when the disease is protracted, of emetics, and shaving
the head. For the cure of Incubus, Mesne and Rhases recommend bleeding
and an attenuant diet. RufTus, as quoted by the latter, recommends vomit-
ing, purging, an attenuant diet, sternutatories, masticatories, and ointments
to the head containing castor and the like.
Psellus gives a very graphic description of incubus.
XVI. ON LYCAON, OR LYCANTHROPIA.
See Aetius, vi. 11. — Oribasius, Syn, viii. 10. — Actuarius, Meth, Med.i.
16. — ^Avicenna, lib. iii. fen. i. tr. 5. c. 22. — Haly Abbas, Theor, ix. 7, Pract,
V. 24. — Alsaharavius, Pract. i. § 2. c. 28. — Rhases, Divis, c. 10., Cont,\ih, 1.
All the other authorities give much the same account of this species of
melancholy as Paulus. If we adopt Dr. Mead's Theory respecting the
dsemoniacs mentioned in Scripture, vee may conclude that the man whose
state is described in Luke, Chap, viii. 27. was affected with this disease. Dr.
Mead is further of opinion that Nebuchadnezzar was seized with Lycao-
thropia.
The Arabian term is Cutubut.
Avicenna recommends the application of the Actual Cautery to the sinci-
put when the other remedies fail. Haly Abbas describes the disease by the
name of Melancholia Canina, He says the patient delights to wander among
tombs, imitating the cries of dogs ; that his colour is pale ; his eyes misty
(tenebricosi), dry, and hollow ; his mouth parched ; and that he has marks on
his limbs of injuries which he has sustained from falls. He recommends tbe
same treatment as our author : indeed, he evidently merely translates this
chapter of Paulus. Alsaharavius seems also to allude to this disease by the
COMMENTARY ON THE THIRD BOOK« 381
name of Melancholia Canhta, Rbases* account of it is quite similar to our
author's.
Schneider has given some interesting Critical Remarks upon this chapter
of Paulus at the end of his edition of Nicander's Theriacs.
Forestus relates that he once met with a case of melancholy answering to
the descriptions of Lycanthropia given by the ancients. — Lib. x. c. 25-
Andreas Laurentius affirms that Lycanthropia is £ndemial in Gascony. — De
Mirah, Strum. Sanat. p. 206. Ader calls the Lycanthropics Loups-garous.
— Euarrationes, c. 5.
XVn. — ON LOVB-SICK PERSONS.
See Oribasius, Synop, viii. 9. — Haly Abbas, Theor, ix, 7., Pract, v. 25. —
Avicenna, lib. iii. fen. i. tr. 5. c. 23. — Alsaharavius, Pract, tr. i, § 2. 17. —
Rhases, Divis. c. 1 1 .
Although Theocritus had declared that neither ointment nor powder is of
any efficacy for the cure of Love, several of the ancient writers on medicine
have given directions for the treatment of desponding lovers*
Rhases, with unusual brevity, merely recommends, in general terms, re-
peated enjoyment, fasting, walking, and frequent intoxication. Avicenna,
Haly Abbas, and Alsaharavius, direct nearly the same treatment ; and also
mention hunting and sports.
XVIIL ON APOPLEXY AND PARALYSIS.
Consult Hippocrates, Aphoris* ii. 42. de Glandulis et alibi* — Galenus,
Comment. J de Loc, Affi iii. 11. — Aretaeus, Morb. Acut. iii. 26. — ^Aetius, vi. 26.
— ^Oribasius, Synop, viii. 14 — ^Theophrastus, ap. Photii Bibliothecam, —
Alexander, x. 2. — Actuarius, Meth, Med, iv. 2.— -Caelius Aurelianus, Morb,
Acut' iii. 5. — Octavius Horatianus, ii. 7. — Nonnus, c. 37. — Avicenna, lib. iii.
fen. i. tr. 5. c. 12. — Avenzoar, lib. i. tr. 9. c. 12. — Serapion, i. 24. — Mesne,
de JEgr. cap* c. 27., de Mgr, Nerv. c. 2 — Haly Abbas, Theor, ix. 6., Pr. v.
22. — ^Alsaharavius, Pract. i. § 2. c 18.-^Rhases, ad Mansor, ix. 3.
To so many excellent works on apoplexy, wherein the subject is treated of
so fully and correctly as to leave little room for further illustration, it is diffi-
cult to do justice within my narrow limits* I shall give, however, a brief,
though imperfect exposition of their opinions.
Hippocrates pronounces a slight attack of apoplexy, to be difficult to cure,
and a severe one to be utterly incurable. It is to be lamented that the dis-
ease still retains its ancient character. He says that an apoplectic attack is
brought on by turgidity of the veins.
Galen states that apoplexy arises from a cold, thick, and viscid humour,
obstructing the ventricles of the brain. He remarks that, in severe cases, all
voluntary motion is lost while respiration is performed as in persons asleep.
The reason which he assigns for this is, that the nerves which are distributed
upon the respiratory muscles are all derived from the brain itself, and these
often escape being injured, unless the attack be of a particularly serious na-
ture.
Celsus* brief account deserves to be given in his own words : — " Atto-
nitos quoque raro videmus, quorum et corpus et mens stupet. Fit interdum
ictu fulminis, interdum morbo : * airfyifkq^iav hunc Grsci appellant. His
sanguis mittendus est: veratro quoque albo, vel alvi ductione utendum.
Turn adhibends frictiones, et ex medi^ materia minimi pingues cibi,
quidam etiam acres ; et a vino abstinendum." Respecting the treatment
382 COMMENTARY ON THE TRIED BOOK.
of paralysis he delivers the following aphorism :— •<< Si omnia membra vehe-
roenter resoluta sunt, sanguitiis detractio vel occidit vel liberat : aliud cura-
tionis genus vix unquam sanitatem restituit, saepe mortem tantum differt,
vitam interdum infestat." His other remedial measures are such as our
author*s, namely, gestation, the application of cupping-instruments or rube-
fecients to the affected part, the warm salt-water bath, and a restricted diet.
According to Theophrastus, paralysis is occasioned by a deficiency or loss
of the pneuma, a. e. vital heat.
It is impossible to admire too much the brief but comprehensive account
of apoplexy and paralysis given by Aretaeus. He states decidedly, that there
is sometimes a loss of motion alone, and sometimes of sensibility ; the reason
of which he supposes to be, that the sensatory and motory nerves are distinct
from one another. This is the germ of a theory fully expanded afterwards
by Galen, and lately revived by Sir Charles Bell of London as a new dis-
covery. It appears, indeed, from the Anatomical Works of Ruffus, that the
lamous Erasistratus had attempted a simitar classification of the nerves.
Galen, however, has the merit of fully establishing the truth of the theory ;
and all subsequent writers on Physiology stated it in nearly the same terms
that he does, until ancient authority in medicine and its cognate sciences
came to be despised, when it was entirely overlooked, until, as we have al-
ready mentioned, it was revived by Sir C. Bell. (See our Commentary, Book
I. c. 63.) He (Aretsus) states it as a general rule, that, when one side of the
brain is affected, the opposite side of the body is paralysed ; but, when the dis-
order is in the spinal marrow, that the affection of the spine and the paralysis
are on the same side. This arises, he supposes, from the decussation of the ce-
rebral nerves ; and this explanation must be admitted even now to be tolerably
correct. Santorini was, I believe, the first modern anatomist who proved that
a decussation takes place at the Tuber Annulare. (See Observat, Anatom, c.
3., and Van Swietan s Comment. § 276.) This anatomical trutli was admitted
by Valsalva and Morgagni, and may now be considered as completely esta-
blished by Tiedeman's Dissections of the Foetal Brain. The causes of paraly-
sis, as stated by him (Aretaeus), are, falls, blows, cold, indigestion, debauch-
ery, intoxication, and violent emotions of the mind. That indigestion or
derangement of the intestinal secretions is occasionally a cause of palsy of
the lower extremities, has been maintained by Mr. Abernethy and other late
writers on this subject. His treatment is as follows : — He inculcates, in the
strongest terms, that the great remedy for apoplexy is venesection ; and that
the only difiiculty, in general, is to determine the extent to which it is to be
carried. He forbids the operation, however, when the senses are oppressed
"with much cold and torpor ;. and Van Swietan considers this as a very pro-
per exception to the general rule of treatment. — Comment, § 1026. When
venesection is contra-indicated, the belly is to be evacuated in order to re-
lieve conjestion there, and to produce revulsion from the head. For this
purpose, acrid clysters are to be given containing nitre, euphorbium, colo-
cynth, turpentine-rosin, and the like. He also recommends biera as a pur-
gative; and, if nausea be present, he advises to encourage vomiting. He
praises castor strongly as a remedy for the nervous affections. ^ The food is
to be light and of easy digestion. When the disease is protracted, cupping-
instruments are to be applied to the back part of the head; When the parts con-
cerned in deglutition, namely, the Fauces and Esophagus, are paralyzed, food
is to be conveyed to the stomach by a suitable instrument. (By the way. Dr.
Freind is mistaken in stating that Avenzoar is the only ancient author who
recommends this practice.) When the bladder is affected, he recommends
injections, but forbids the use of the catheter for fear of occasioning convul-
sions or gangrene. He approves greatly of the bath of oil in this case.
Aetius, Oribasius, Alexander, Actuarius, and Nonnus, treat of the disease
COHlfBNTART ON THB THIRD BOOK. 383
in mucb the same terms as our author. Alexander, in particular, properly re-
commends moderate purging with the hiem and such like medicines,
Caelius Aurelianus enumerates nearly the same causes of apoplexy and
paralyis as Aretxus, namely, excessive heat, cold, ipdigestion, debauchery,
and injuries of the brain. The season of winter is justly said to predispose
to the disease. It is seated, he says, principally in the head. His treatment
is nearly the same as that of the followers of Hippocrates and Galen, namely,
emollient applications to the head and limbs, venesection, abstinence, clys-
ters, cupping the back part of the head, and the bath of oil. Of paralysis
he treats at greater length, and with much precision and judgment. He men-
tions nearly the same causes of it as of apoplexy ; and remarks that it pro-
duces loss of, sensibility, or of motion, or of both. He observes, in particu-
lar, of the tongue, that it may retain the power of deglutition although that of
speech be lost. He details all the phenomena of partial paralysis with sur-
prising accuracy ; and, at the present day, I do not know a work on the sub-
ject that contains so much information. He distinctly and accurately de-
scribes paralysis of the Esophagus and Fauces. His treatment is, upon the
whole, not very different from our author's ; but his directions for the appli-
cation of his remedies are exceedingly minute and judicious. In the first
place, he approves generally of venesection, calefacient applications to the ex-
tremities, a spare diet, and afterwards of cupping and scarifications. When
the tongue is affected, hot gargles of mustard and vinegar are to be given ; and,
when there is paralysis of the bladder, the catheter is to be used. When the
disease is obstinate, he approves of hellebore as an emetic, and of calefacient
plasters, depilatories, cupping with much heat, embrocations of mustard, and
such things as will produce a papular eruption, namely, flour of salt, nitre,
and the like. He blames Praxagoras for recommending emetics indiscrimi-
nately, and Erysistratus for omitting venesection. He finds fault with The-
mison for being in too great haste to apply stimulants to the affected parts,
and for having recourse to cupping before the disease had begun to subside.
Though he permits the occasional use of hellebore, he disapproves of purga-
tive medicines in general. For paralysis of the Esophagus he recommends
to apply a cupping-instrument, leeches, or cataplasms to the neck.
Little additional information is to be got from the Arabians; and yet Avi-
cenna, in particular, has treated the subject in a very masterly manner. The
causes of apoplexy, he says, are either obstruction or repletion; and these are
produced either by blood or a pituitous hnmour. I need scarcely remark,
that this accords with the modern division into Sanguineous and Serous Apo-
plexy. Even in Pituitous Apoplexy he admits of venesection, in which
practice he is followed by Cheyne and Abercrombie, the best of our late au-
thorities on this subject. He approves of vomiting when it can be produced
easily. Neither Serapion nor Avenzoar make mention of venesection. Se-
rapion commences his treatment with an emetic. It may be proper to men-
tion, that Dr. Abercrombie rather approves of emetics in cases of apoplexy.
When connected with plethora, Alsaharavius recommends general bleeding,
opening the temporal veins, cupping the legs, restricted diet, applications to
-the head, such as oil of roses and vinegar, and acrid clysters. Haly's ac-
count is minute and judicious. He attributes the affection to obstruction
within the brain occasioning a loss or diminution of the powers of sensation
or of voluntary motion. It is produced, he says, by phlegm mixed with bile or
blood ; and sometimes arises from repletion with wine, which case generally
proves fiital. He justly remarks, that one of the most common symptoms
is stertorous breathing. If the face be ruddy or livid, he directs to open the
cephalie vein, or vena saphena, and abstract blood according to the patient's
strength ; to apply ligatures to the extremeties ; vinegar and rose-oil to the
head; and to give clysters. He also approves of emetics. When the dis-
384 COMMENTARr ON THE THIRD BOOK.
ease has partly subsided, he directs to use the bath. He treats separately
of paralysis, describing many varieties of it. In paralysis of the face he re-
commends stimulant liniments, ligatures, gargles, and sternutatories. Accord-
ing to Rhases, apoplexy arises from conjestion of blood or of viscid phlegm
in the brain. He remarks correctly, that, when attended with stertor, it is
difficult to cure. When the memory is affected, he directs to apply a si-
napism to the occiput.
The paralysis of the extremities aAer Colic, mentioned by our author, and
after him copied by Avicenna and Haly Abbas, was, no doubt, the same dis-
ease as the palsy after Colica Pictonum described by modern authors. De
H'aen has given a masterly description of this disease.
Rhases states decidedly that the skin of paralytics may retain its sensibility
although the muscular motion be lost. In a word, he maintains that the nerves
of sensibility and motion may be affected separately. He remarks, however,
that a part can scarcely retain its powers of motion when the sensibility is en-
tirely gone. Some extraordinary examples of this, however, are related by
modern authors. — See Mem. of the Royal Acad, of Sciences. He says, that
he had known several cases of paralysis cured by a natural diarrhoea. His
general remedies are bleeding, purging, and rubefacient applications. He,
and several of the authorities referred to by him, recommend the warm salt-
water bath for the cure of paralysis.
The pathology of Simple Apoplexy is still very obscure. Upon the whole,
the ai^cient doctrine of its arising from obstruction of the brain is as probable
as any other theory. — See Dr. Abercrombie on the Pathology of the Brain. —
Appendix ^o P. II.
XIX. ON CONVULSIONS, OR SPASMS.
See Hippocrates, Aphor. v. 70. — Oalenus, Comment, de Loc, Aff. lib. iii.,
Meth, Med. lib.xii. — Celsus, ii. 1. — Cselius Aurelianus, Morb. Acut, iii. 6. —
Aretsus, de Morb. Acut. i. 6. — Nonnus, c. 38. — Octavius Horatianus, ii.
10. — Aetius, vi. 38. — Oribasius, St/n. viii. 16. — Avicenna, lib. iii. fen. 2,
c. 5, 6, 7. — Serapion, i. 27. — Avenzoar, lib. ii. tr. 3. c. 16., and lib. i. tr. 10.
c. 3. — Alsaharavius, Fract. i. § 2. c. 21. — Rhases, Divis. i. 16., and Con-
tinens, lib. i.
Aetius and Oribasius treat of spasms in nearly the same terms as our
author. We shall give an account of the doctrines of Aretseus and Cxlius
Aurelianus in the next chapter. The principles of our author's treatment are
mostly derived from Galen. The Arabians adopt his views without the
slightest modiiication.
XX. — ON TETANUS.
Consult all the works referred to in the preceding chapter; also, Celsus,
iv. 3. — Haly Abbas, Theor. ix. 10, 11., Pract. v. 31. — Alexander Apbro-
disieus, Problem. \. 53.
Hippocrates, Galen, Horatianus, and Avicenna, agree in stating, that a
fever coming on tends to remove the tetanic affection. Cselius Aurelianus
seems to question the truth of this ancient aphorism. Hippocrates disapproves
of the cold affusion in cases of Traumatic Tetanus. Alexander Aphrodisieus,
however, speaks rather favourably of it.
Aetius, Oribasius, and Nonnus, like our author, recommend bleeding, emol-
lient fomentations, and the bath of oil. Archigenes (ap. Aetium) directs to
prepare the bath by adding a fifth part of oil to the water.
COMMENTARY ON THE THIRD BOOK. 385
Tlie treatment recommended by Celsus is judicious and not unlike our
author's. He expresses himself hesitatingly about venesection, and forbids
the early use of wine, lie approves of opening the belly. This practice is
strongly recommended by Dr. Hamilton of Edinburgh.
Aretsus says that Tetanus is a painful spasm, sometimes proving speedily
fatal, and always ditiicult to cure. Like the moderns, he mentions the three
varieties of it, namely £mprosthotonos, Opisthotonos, and Tetanus. The
disease, according to his account, may arise from a variety of causes, such as
a wound of a muscular or nervous part, abortion, and excessive cold. When
it arises from the two causes first mentioned, it is said to be generally fatal.
His description of it is given in his usual graphic manner. His treatment is
altogether soothing and relaxant. He recommends to lay the patient upon a
soft warm bed, and, from whatever cause the complaint arise, to begin with
abstracting blood from the arm. Then soft liquid food is to be given, and
the whole body wrapped in wool, moistened with some calefacient oil ; or
bladders half filled with tepid oil are to be applied to the parts most affect-
ed. He directs to cup the back part of the neck, but cautions against excit-
ing irritation hy the application of heat. To the wound he recommends sup-
purative applications containing frankincense, turpentine-rosin, and the like;
for he remarks (and tlie fact is confirmed by the experience of the late M.
I^rrey, who recommends a similar mode of practice) that, when tetanus su-
pervenes, the sore becomes dry. He praises castor and assafoetida as anti-
spasmodics ; and, if these cannot be swallowed, they are to be given in an in-
jection. He advises also to give hiera in an injection.
Cslius Aurelianus enumerates nearly the same causes as Aretccus, and de-
scribes all the symptoms of the disease with the greatest precision. His
treatment also is nearly the same as that of Aretaus, namely, emollient appli-
cations to the neck, venesection, and oily clysters. He even enjoins the baih
of oil, which has fallen into disuse in modern practice, most probably solely
on account of the expense with which it would be attended. He also permits
^sometimes to use the common bath, but not of cold water. He allows wine
in certain cases. He condemns Hippocrates for giving both wine and eme-
tics, and having recourse to venesection, without due discrimination. He
blames him also for recommending the affusion of cold water, in as much as
he himself had pronounced cold to be injurious to the nerves, bones, &c.
Galen, however, remains, in his Commentary upon this Aphorism of Hip-
pocrates {Sect, V. 21.), that cold, in this case, is not the direct cause of the be-
nefit derived from this remedy, but {if I understand him right) that the shock
which it imparts to the system proves beneficial by rousing the vital heat and
energies of the patient. Hippocrates, however, as stated above, forbade the
cold affusion in Traumatic Tetanus. Our author's opinion of this practice is
just such as the profession in general now entertains, after it has received
another trial upon the recommeiidation of the late Dr. Currie. — (See Medical
Reports, and Larrey's Memoires de Chirurgie, t. 1 .)
Octavius Horatianus recommends bleeding, emollient applications, purga-
tive clysters, the tepid bath, antispasmodics, and soporifics. The use of the
last-mentioned class of remedies does not appear to have been suificiently
understood by the ancients : at all events they were less partial to them in
this case than the moderns.
The Arabians enjoin nearly the same treatment as the Greeks. Avicenna
and Mesne join the preceding authorities in recommending strongly the use
of castor and assafoetida as antispasmodics; and yet it is deserving of re-
mark, that modem sui^eons do not repose much confidence in these medi-
cines.— (See Sir James M*Grigor's communication in the Medico- Chirurg.
Transact, v. vi.) Avicenna, like all the others, praises the bath of oil. Se-
rapion speaks of a bath prepared with emollient herbs. Haly Abbas describes
c c
386 COMMBNTAET ON THB THIED BOOK.
minutely the two varieties as occasioned by repletion or inanition. For the
former, he approves of purging with hot drastic purgatives, of nibbing the
part affected with hot oils, and of using the warm bath with friction after it.
He also approves of castor. For the other variety, he praises the affusion of
plain water in which lettuces, barley, &c. have been boiled. He recom-
mends the internal use of milk and other demulcents, and the bath of oil,
and rubbing the body with oil of violets. The treatment recommended by
Alsaharavius is very similar. Rhases mentions Hippocrates' proposal of the
cold affusion ; but, like our author, he rather disapproves of it. He himself
recommends bleeding, when there are symptoms of repletion, emollient ap-
plications to the neck, the bath of oil, the application of leeches to the part
affected, purging with aloes, &c. and the administration of antispasmoaics,
such as castor, assafoetida, and the like.
XXI. ON TRBMOBS.
See Galenus, rfc Tremorcy et alibi, — Nonnus,c. 40. — CsBlius Aurelianus, £2e
Morb, Acut. iii. 7. — Mesne, de J£gr, Cap, c. 5. — Serapion, i. 3. — Haly
Abbas, Theor. ix. 11., Pract, v. 32. — Alsaharavius, Pract. i. § 2. c. 24. —
Rhases, ad Mamor, ix. 8.
Galen, in the work referred to above, explains the rationale of this affection
with his usual penetration, but at too great length to allow my entering upon an
exposition of it. The others treat of it similarly to our author. Thus Haly
Abbas mentions various causes of Tremors, such as old age, drinking cold
water unseasonably, excessive indulgence in wine or venery, inanition, and
the like. He recommends aloes and castor, the hot bath, friction with cale-
facient oils, and other such remedies. Serapion gives a sensible account of
the nature of the affection ; and recommends foetid or antispasmodic remedies
internally, and friction with calefacient oils exteraally. When it is occa-
sioned by exposure to cold, Rhases recommends the hot bath and inso-
lation.
XXIT. ON DISBASRS OP THB BYB.
See Hippocrates, Aphoris., de Visu, et alibi. — Galenus, de Loc, Aff. iv.,
de Med. sec. loc. lib. iv. — Aetius, lib. vii. — ^Alexander, lib. ii.— Oribasius,
S^n. lib. viii. — Actuarius, Melh. Med, iv. 11. — Psellus, Opus Medicum, —
Scribonius Largus. — Octavius Horatianus, i. 10. — Nonnus, Epit, c. 45. —
Serapion, tr. ii. — Avicenna, lib. iii. fen. 3. tr. 1,2. — Mesne, de AEgrit. Octd,
— Avenzoar, i. tr. 7. — Haly Abbas, Theor. ix. 13., Pract. v. 34. — ^Alsahara-
vius, Pract. iv. — Rhases, Divis., ad Mamor. lib. ix., and ContinenSf lib. ii.
— Canamusali, de Oculis, lib. vi. — Jesu Haly, Tract, de OctUis,
One may venture to affirm that whoever will carefully study the works of
all the ancient authors referred to above will find every subject connected
with Diseases of the Eye treated of so fully and judicio«isly, that he will not
stand much in need of consulting modem writers for additional information.
I have to lament that my limits do not enable me to do full justice to them.
On the anatomy of the eye Jesu Haly is particularly deserving of attention.
His whole work, in fact, is highly valuable.
On Pain, Disorder of the Ei/e, Ophthalmy, Inflammation^ and Defluxion.
— The ancients treat of these complaints separately ; but, as they are so nearly
connected, we shall class them together. By disorder of the eye {Taraxis),
they meant an inferior degree of ophthalmy, as is remarked by Turnebus.
COMHBNTARY ON THE THIRD BOOK. 387
(Beroard*s Nonnus. c. 45.) It is, therefore, the mild acute ophthalmy of
Scarpa. The remedies enumerated by Hippocrates for pains of the eyes are
thus given in the language of Celsus: — '^Sanguinis detractio, roedicamentum)
balneum, vinum.** Drinking wine might appear to us at 6rst sight not a
very likely mode of curing ophthalmies ; and yet Galen in his Commentary
on this Aphorism (sect. vi. 3t.) has related a case in which it effected a cure
after every other remedy had failed. Even Scarpa allows the correctness of
the Aphorism as a rule of practice, and states that wine and the cold bath
are proper when the disease is kept up by excessive irritability. Alexander
recommends wine and the tepid bath when the inflammation arises from thick
and pituitous blood. Mesne makes many interesting remarks upon the above-
mentioned remedies of Hippocrates. For further explanation of the rationale
of this practice, see Schelhammer, de Tumoribus, Another of Hippocrates*
Aphorisms is, that a spontaneous diarrhoea is a favourable occurrence in oph-
thalmy-; upon which Galen remarks that, in imitation of nature's method of
removing the complaint, physicians are in the practice of producing an ar-
tificial looseness by means of cathartics and clysters. Lead is an ingredient
in several of Alexander's collyria. For periodical ophthalmy, Hippocrates
recommends purging the head and bowels, in certain cases bleeding, cup-
ping, and restricted diet. Celsus, Galen, and, in short, most of the ancient
authorities make mention of narcotics, such as opium and mandragora, but
do not approve of them as common remedies. Galen, however, instances
ophthalmy as one of the species of inflammation in which opium is admissi-
ble. (V. de Optima Recta, c. 9.) Aetius lays down very proper rules re-
specting purging, fomentations, venesection, and baths. He properly re-
marks regarding the use of wine, tliat it is only applicable when the patient
is of a dry and cold intemperament. Celsus is a decided advocate for fo-
mentations with hot water in all cases of ophthalmy.
The Arabians treat ophthalmy upon the same principles as the Greeks
without supplying much additional information. Mesue, like our author,
recommends bleeding by opening the temporal artery, which operation he
describes minutely. When the bleeding cannot be stopt otherwise, he directs
to secure the vessel with a silk thread. He also makes mention of leeching
and the Actual Cautery. He is very minute in his directions about his col-
lyria. One of his anodyne collyria consists of the juice of liyoscyamus, man-
dragora, and opium ; and another contains camphor, saffron, hyoscyamus, and
the like. The use of narcotics, however, is forbid by Jesu Haly. Rhases
also rather disapproves of them. Avicenna makes mention of bleeding by
the temporal arteries, the angular vein of the nose, and the frontal. When
the usual remedies do not succeed, he approves of the Cautery; and, in cer-
tain cases, recommends strongly the use of stimulant applications, such as
«s ustum, copperas, and arsenic. Galen, in like manner, makes mention of
arsenic, and also of misy, sori, and chalcitis (substances resembling our sul-
phate of copper) among his remedies for diseases of the eye. Having myself
had occasion to use arsenic in certain malignant diseases of the eye-lids, and
not having found that it produced any serious disorder in the ball of the eye,
I would call the attention of modem oculists to this medicine as one from
which, when properly managed, the best results may be expected. When
the o|^thalmy is of a cold nature, Avicenna approves of treating it by an at-
tenuant diet, the bath, and white wine. In certain cases he directs to pour
cold water on the head. Haly Abbas describes three varieties of ophthalmy.
The 1st arises from manifest causes, such as the sun, dust, and the like; and
is to be cured by bleeding, purging, and cooling lotions containing rose-oil,
camphor, &c. In the 2d, the symptoms are more severe, being attended
with greater redness and J^in. It also is to be cured by bleeding, cupping,
and emollient collyria. Tlie 3d variety is chemosis. Alsaharavius treats of
c c 2
388 COMMENTARY ON THB THIRD BOOR.
•
the disease at great length. When it is connected with a bilious cause he
directs to purge, use the bath, apply vapours to the eye, and soothing col-
lyria. Serapion, like Haly, describes three varieties of the disease by the
names of TarkinisiSf NouteiinUy and Kermufil. Jesu Haly recommends ge-
neral bleeding, purging, and fomentations with the decoctions of fenugreek
and fennel for ophthalmy. — It remains to be mentioned, that Galen, Rhases,
Alexander Aphrodisieus, and other ancient authorities, have placed oph-
thalmy in the list of contagious diseases. (See, in particular, Alex. Aph.
Prob. i. 35.) The celebrated Fracastorius confidently maintains that oph-
thalmy is contagious. — De Morb, Contag. The ophthalmy which was im-
ported to this country from Egypt by the British army about thirty years
ago was generally acknowledged to be contagious. See the works of Vetch,
M*Grigor, and others.
On Cfiemosis, — By Cheraosis modem oculists (as, for example, Scarpa)
understand that state of ophthalmy when blood, owing to a rupture of one or
more vessels, is effused into the cellular membrane which connects the con-
junctiva to the anterior hemisphere of the eye. Our author's account is
mostly taken from Oribasius, who, in his turn, borrows from Demosthenes.
Galen and Octavius Horatianus, without saying any thing of the general
treatment, merely recommend to apply upon a clean linen cloth flies pounded
with the yolk of an egg. Chemosis is Haly's 3d variety of ophthalmy, for
which he recommends copious and repeated bleeding, cupping, gentle laxa-
tives, cataplasms containing poppies when the pain is violent, and other
soothing collyria. Alsaharavius, in like manner, recommends depletion and
emollient fomentations. Serapion, among other things, mentions soothing
fomentations. In chemosis, according to Rhases, all the symptoms of oph-
thalmy are particularly strong and violent; the eye-lids being swelled and
everted, and the white of the eye appearing black. He recommends local
and general bleeding, purging, and astnngent applications.
On HyiHinphugma and Emphysema. — Hyposphagma is not described by
any particular name in modern Surgical Works. Besides the local applica-
tions mentioned by our author, Aetius properly recommends general treat-
'ment, 1 mean bleeding, purging, and the like. Avicenna also makes men-
tion of venesection and arteriotomy. Ilaly describes the disease by the name
of Tumor Oculi as his 1st variety of Injiatio, Alsaharavius uses the same
term. Serapion treats of it by the name of Sanguis Divisus in OctUo, recom-
mending treatment similar to our author's. See also Celsus, vi. 6.
The Emphysema appears to have been a sort of CEdema seated below the
eye-lid. Aetius remarks that it occurs principally in old men. I have often
seen it in them lie recommends fomentations by means of a sponge, rubbing
the eye-lid within with honey, pouring hot water on the head, using baths,
drinking wine, and even bleeding at the arm. This last measure is omitted
by our author, and musr be unnecessary in general. It is described by Haly
Abbas as his 2d variety of Injlatio Oculi, He says it is an oedematous
swelling principally affecting old men in summer. He recommends collyria
of a sharp penetrating nature and various other applications.
On Fsor ophthalmia, Sclerophlhalmia, and Xerophthalmia. — For these af-
fections Aetius gives various prescriptions containing calamine, burnt cop-
per, chalcitis, and the like. Similar ones may be found in Gralen, sec. loc.
Galen, like our author, recommends fomentations by means of a sponge with
hot water or the decoction of poppies. One of Alexander's prescriptions for
Psorophtliulmia contains arsenic. Celsus describes the symptoms and treat-
ment of Xerophthalmia very minutely; " Neque tument, neque fluunt oculi,
sed rubent tan turn, et cum dolore quodam graves sunt, et noctu pra gravi
pituita inhaerescunt." lie gives the sum of his treatment in this short sen-
tence : '* In hoc vitio multum ambulare, multum exerceri, lavari saepe, ibique
' COMMENTARY ON THE THIRD BOOK. 389
desudare, muU^ue frictione uti Decessarium est." lie also prescribes gar-
gles, food of a middle quality, and various compound collyria, such as the
ilhinion which contained burnt copper, myrrh, Phrygian stone, &c. He re-
commends this collyrium also for the psorophthalmia, which he describes by
the name of Scabri Oculi, For this last-mentioned affection he recommends
various stimulant applications ; and, when other remedies are not at hand,
directs to apply bread pounded in wine. The psorophthalmia is the Prurigo
Oculi of Ilaly Abbas, for which, among other things, he recommends a com-
position containing pepper, sal ammoniac, saffron, sp;kenard, camphor, &c.
He rtescribes Sclerophthalmia by the name of Durities Oculiy and recom-
mends for it bleeding, gentle purgatives, emollient collyria, &c.
On Ectropion. — Aetius, in like manner, recommends compositions con-
taining eerugo aeris, misy, and chalcitis. None of the subsequent authorities
supply any additional information. Alsaharavius in particular gives a very
accurate account of the disease, which, when it arises from a fungous ex-
crescence growing from the inner side of the eye-lid, he directs to burn with
caustics ; but, when it arises from a cicatrix, it is to be cured only by a sur-
gical operation. This will be found described in the Sixth Book. In place
of the caustics recommended by the ancients, Scarpa directs to apply thp
argentum nitratum.
On Mgilopi and Anchilops. — These are different stages of the disease now
known by the name of Fistula Lachrymalis. Galen states that at the com-
mencement it is to be cured by applications which are repellent without
being too stimulant. He gives a full account of the treatment recommended
by Archigenes. The first application mentioned by him is a cataplasm consist-
ing of tares and honey. Scarpa, by the way, speaks favourably of the practice
of TEgineta, Aetius, and Avicenna. Avicenna treats of the disease with great
judgment. His first applications appear to have been intended to produce
resolution ; and, if these fail, suppuratives are to be applied. Wheo the
abscess bursts, the sore is to be reduced to a healthy state by escharotic
powders containing alum, limatura sris, sal ammoniac, and the like. When
these fail a surgical operation must be had recourse to. This is described
in the Sixth Book. Mesue also has treated of the disease at great length.
Ilaly Abbas describes the disease very correctly. . He says, " Aliquando
autem ejus sanies ad nares defluit per foramen quod inter oculum est et
nasum.'' This passage puts it beyond a doubt that the ancients were ac-
quainted with the Lachrymal Duct. The disease, he says, sometimes occa^
sions caries of the cartilages (os unguis ?). When it is recent, he recommends
bleeding and laxatives ; and, when it gets into a fistulous state, he directs to
use applications containing arsenic, sal ammoniac, cantharides, alum, &c.
Alsaharavius mentions that the abscess of the Lachrymal sack may either
burst outwards or into the nose. It would appear, therefore, that he also
was acquainted with the natural structure of these parts. One of the appli-
cations recommended by Rhases for Fistula Lachrymalis contains arsenic,
quicklime, and vitriol. Another is prepared from litharge, arsenic, and oil.
These applications are mentioned by the earlier of the modern authorities on
medicine. See Theodoricus, lib. iii. c. 2.
The Protastactos mentioned by our author was a composition consisting of
potass and lime. See Book Seventh, in voce, Kopia.
On Trachoma, — This affection does not appear to be noticed in our late
treatises on diseases of the eye, and yet in my own practice I have met with
some cases of it. Rowley mentions it as an asperity of the internal super-
ficies of the eye-lid. Celsus describes it by the name oi Aspritudo. In se-
vere cases, he says some scarify the inside of the eye-lid with a fig-leaf, a
rough probe, or a scalpel. Bift, in ordinary cases, he rather approves of
using exercises, frequent baths, fomentations with hot water, attenuant food,
390 COMMBNTART ON THB THIRD BOOK.
and escharotics, such as copperas, misy, aDtimony, and the like. Galen and
Aetius give prescriptions for various collyria. They consist principally of
detergent and caustic substances, such as sal ammoniac, squama aens, cala-
mine, and the like. It seems to be the disease which Haly Abbas treats of
by the name of Lapidositas. — Pr, v. 51.
On Chalazion, — We vfiW treat more fully of the nature of this tumour in
our notes on the Sixteenth Chapter of the Sixth Book. It appears to be the
species of encysted tumour said by Scarpa to be well described by M. Aure-
lius Severinus. — On Diseases of the Eye, c. 3. Rowley describes it as a
moveable tumour in the margin of the eye-lids. Aetius recommends to open
the tumour with a scalpel, and apply to it escharotics, such as burnt copper,
chalcitis, and red arsenic. By Haly Abbas it is called Grando, and the
remedy mentioned by our author is recommended by him. Alsaharavius de-
scribes it as a gross humour congealed in one of the eye-lids. He describes
by the name of Alsaanac a fatty tnmour of the eye-lids which I have some-
times met with and extracted. On the Chalazion see Celsus, vii. 7., and Isi-
dorus, Orig. iv. 8.
On Hordeolum. — Most of the ancient authors treat of this trifling com-
plaint in much the same terms as our author. Scarpa evidently is mistaken in
making the Hordeolum and Chalazion to be the same complaint. Haly Abbas
describes it as being an oblong abscess resembling a grain of barley on the
extremity of the eye-lid. He reeommends general depletion, and nearly the
same remedies as our author, also a cataplasm of galbanum. Alsaharavius
treats of it in a similar manner. Rhases particularly recommends melted
wax as an application to it. He also speaks favourably of the diachylon
plaster.
On Lice in the Eye-hrmos. — Stavesacre is a very ancient remedy for
pediculi on all parts of the body. Celsus lays down very minute directions
for the constitutional treatment, and recommends a local application con-
tdining sandarach, or the red sulphuret of arsenic. Avicenna makes mention of
sulphurous baths. Ilaly Abbas recommends general purging, various stimu-
lant applications, and abstinence from ligs. Our author states, in the Eighty-
fi^rst Chapter of the First Book, that figs engender lice. Alsaharavius directs
to rub the eye-brows with sal ammoniac, alum, salts, &c. Jesu Haly recom-
mends purging with hiera, the frequent use of the bath, and applications con-
taining stavesacre, sulphur, alum, nitre, sal ammoniac,, vinegar of squills, and
the like. Rhases recommeEkds a powder containing quicksilver.
Mercurial ointment is now generally used for curing phthiriasis. See
Rowley on Diseases of the K)res.
On Madarosis, or Milphosis, and Ptilosis, — Aetius,. Actuarius, and Nonnus
treat of these diseases in similar terms. The calliblephora are fully described
by Galen, sec, loc. lib. iv. Haly Abbas seems to allude to these complaints
in the following sentence: — ''Palpebrarum autem casus ex humiditate fit
acut^ aut alopetia, et quidam fit cum palpebrarum grossitie et duritie,
ruboreque, et dolore.'' His remedies are like our author's. The same may
be said of Alsaharavius.
On Trichiasis, — Our author's treatment is mostly imitated firom Galen.
We shall treat more fully of the disease in the Sixth Book. Scarpa places
no confidence in the operation of plucking out the hair, and yet it is favour-
ably spoken of by most of the Greek and Arabian authorities, as, for
example, Aetius, Avicenna, Alsaharavius, and Haly Abbas; and also by
Rowley, and other modem oculists. Haly, like our author, directs to toucK
the part from which the hair has been plucked with the blood of a frog, or
of a dogVtick, or with the milk of a fig, or the gall of a hedge-hog. Alsaha-
ravius makes mention of the same remedies, and also of the mode of treating
it by aggliuinants. According to At tuarius, the disease consists in certain
COMlfBNTART ON THE THIRD BOOK. 391
of the ciliary hairs being turned inwards and hurting the eye-ball. — Lib. ii.
c. 7.
On Encanthis and Rhyas, — Scarpa removes the Encanthis by a surgical
operation; — but, from my own experience of the effect of septic medicines,
such as arsenic, in similar complaints, I cannot doubt the propriety of the
ancient practice. Galen's applications contain copperas, misy, sal ammoniac,
and the like. Those of Aetius are nearly the same. lie remarks that sea-
men are particularly liable to the complaint. Haly Abbas recommends
general evacuation and escharotic applications.
On Ulcers, — In the description of the Ulcers of the Eye our author follows
Aetius. He, however, evidently was much indebted to Galen, sec, loc. lib*
iv; The Arabians copy from Galen, describing like him seven varieties of
ulcer, which they treat upon genersil principles. See, in particular, Haly
Abbas, Fract. v. 41. Opium is one of his medicinal articles. Ceruse,
starch, gum arable, albumen, &c. also occur. See also Jesu Haly, tr. ii. c.
50., and Rhases, Cont, lib. ii. Celsus recommends various compound appli-
cations for ulcers of the eye, which he treats of very minutely.
The coUyria mentioned in this chapter will be found described in the
Seventh Book of this Work.
On Procidentia, — Galen correctly describes Procidentia as arising from
ulceration of the cornea and protrusion of the iiis. — De Diff. Morb, c. 13.
Aetius has treated of it with his usual accuracy. He recommends vai'ious
escharotic applications containing chalcitis, misy, and the like, which, when
properly managed, may probably have answered the purpose equally well with
the antimonium muriatum and argentum nitratum used by Scarpa and other
modem oculists. Avicenna treats of the complaint like the Greeks. Some
of his compositions contain antimony with ceruse, burnt lead, and the like.
Haly Abbas describes the disease minutely in nearly the same terms, and re-
commends nearly the same remedies as our author, namely such as are of a
repressing nature. He properly remarks, that it is one of the consequences
of ulceration of the cornea. Alsaharavius gives a similar account, and re-
commends general depletion.
On Hypopyon, — Aetius gives much more judicious directions for the
treatment of this complaint than our author. He properly recommends ge-
neral blood-letting at the commencement, and afterwards local, by means of
leeches and cupping-instruments ; and then emollient, paregoric, and discu-
tient applications to the eye. Galen (Meth. Med,) makes mention of an
oculist in his time who effected wonderful cures in this complaint by shaking
tlie patient's head. When this does not succeed, Galen directs to perforate
the coats of the eye, and let out the matter. — See Book Sixth. Scarpa does
not approve of this practice, unless the collection of matter be considerable.
However Plempius and most of the earlier modem authorities in surgery
decidedly recommend it. Haly Abbas recommends a discutient cataplasm
containing opoponax, ammoniac, and fenugreek. Alsaharavius properly airects
bleeding and masticatories at the commencement.
On Leucoma, — Aetius directs his attention principally to the general
treatment, and properly cautions against the use of strongly-stimulant appli-
cations, as they only increase the evil. He allows afterwards moderately
detergent ones containing verdigris, burnt copper, squama eeris, flos sris, sal
ammoniac, and the like. His compositions are taken for the most part from.
Galen's work, de Med, sec, loc, lib. iv. Aetius disapproves of applications
for changing the colour of the leucoma. Alexander recommends the deter-
gent applications mentioned by our author. Nonnus copies from him. Haly
Abbas describes it by the name of Albedo Oculiy and recommends nearly
the same remedies as our autlior. He particularly praises green glass finely
pulverised, which is still a popular remedy in Scotland. Alsaharavius makes
392 ^ COMMENTARY ON THB THIRD BOOK.
mention of the juice of the Lesser Centaury as an useful application. Scarpa
speaks favourably of this remedy, and further recommends the sappbirian
coUyrium, the ingredients of which are similar to those which entered into
the ancient applications. It consists of a solution of 2 B of sal ammeniac
and 4 gr. of aerugo in 8 oz. of aqua calcis, allowed to stand for twenty-four
Ivours, and then Altered. Hhases recommends an ointment contaioing
arsenic.
On Pterygium. — Aetius correctly remarks that Pterygium generally be-
gins from {he inner canthus, rarely from the outer, and scarce ever firom
above or below. lie gives piescriptions for a variety of applications^ which,
like our author's, contain burnt copperas, magnesian stone^ sal ammoniac,
and the like. Galen briefly commends the same. Nonnus, Serapion, and
the others approve of this practice. Modem oculists, however, trust to no-
thing but the operation, which will be described in the Sixth Book. Haly
Abbas describes the disease very accurately by the name of Ungula ; and re-
commends general bleeding, purging, restricted diet, and a variety of colly ria.
Aisaharavius gives the same account of the ungula, and, when it becomes cal-
lous (nervosus), recommends an operation. Jesu llaly recommends, before
attempting a surgical operation, to make trial of escharotic applications.
Rhases also approves of this plan of treatment. The most active ingredients
in his prescriptions are sal ammoniac, copperas, and arsenic. Some of his
compositions are merely detergent.
On Carbuncle and Lancer. — I am not aware that the parts about the eye
are particularly liable to anthrax, nor do I recollect to have ever met with
such a case ; and yet, as Alexander and our author remark, the disease may
occur there as well as in other parts of the body. Rowley describes Carbun-
cle both of the eye and eye-lids. Aetius has given a very circumstantial ac-
count of the symptoms and treatment of anthrax. He forbids the early
application of cataplasms, and seems to depend most upon constitutional
treatment, by clysters, purging, and bleeding. Afterwards cooling and
5rtyptic fomentations are to be applied by means of a sponge, along with other
treatment similar to our author's. Alexander's plan of treatment is nearly
the same, and is laid down with excellent judgment. That of Oribasius is
similar.
To relieve the pains of Cancer, Aetius recommends soothing applications
and an anli-stimulant diet consisting principally of milk. Avicenna, Aisa-
haravius, and most of the ancient authorities join in praising milk as the
principal article of food in cancer of the eye. Mr. Pearson, of the Lock
Hospital in London, expresses himself strongly in favour of its powers for
palliating the sufferings in cases of cancer of the womb ; but I cannot say
that my own experience leads me to entertain any high opinion of its reroe-
<lial powers in any form of this disease. Avicenna's applications contain
ceruse, opium, and the like, ilaly Abbas recommends general bleeding, if
the patient's strength permit, with emollient lotions, and collyria: — the diet to
consist of birds, kids, and lambs. According to Rhases, cancer ok the eye is
attended with excruciating pains, redness, and distension of the veins, loss of
appetite, and inability to bear all applications.
On Mydriasis. — Aetius treats Mydriasis, or preternatural dilatation of the
pupil, like our author, by general and local bleeding, clysters, an attenuant
diet, and friction of the extremities. They no doubt considered that the
disease arises from congestion in the brain. Avicenna refers the disease to
Cephalaea and injuries of the head. Scarpa quotes with approbation the
account given by Celsus of mydriasis, by which he thinks was meant not only
cases of dilated pupil but also of incipient amaurosis occurring suddenly.
(VIsus ajiproves of opening the bowels freely. I laiy Abbas describes the
disease, i)ut thinks it almost incurable. It sonactimes occurs, he says,
COMMBNTART ON THE THIRD BOOK. 393
from a blow, and sometimes from abscess within the uva. Alsaharavius
attributes the disease to congestion ; and directs to treat it with bleedings
purging, and cooling applications. He calls it Dilatatio. According to
Jesu Haly, it is produced by dryness of the uva, or abscess within that
tunic, or pressure on the brain. The first species is to be relieved by
diluents and relaxants, such as the warm bath. For the second he recom-
mends suitable cataplasms and purgative pills. The third is to be treated by
general and local bleeding, cupping, and fomentations with water, vinegar,
and salt. Constriction of the pupil he directs to treat upon the same princi-
ples as our author. His account of it is mostly taken from Aetius.
On Nyctalopia, — Aetius recommends, according to the circumstances of
the case, general and local bleeding, drastic purgatives, errhines, and the like.
He, Celsus, Alexander, Rhases, Avicenna, Mesne, Jesu Haly, Haly Abbas, and
Aisaharavius, like our author, speak favourably of the application from the
roasted liver of a goat ; and yet Scarpa questions its efficacy. Instead of it Hip-
pocrates recommends the liver of an ox. His treatment otherwise consists ol
bleeding, purging with elateriura, and, in desperate cases, of trepanning the
head at the bregma and evacuating the water. — t)e Vim. The general treatment
of the Arabians is like that of the Greeks. Thus Aisaharavius recommends
bleeding, purging with hiera, gargles, sternutatories, and the like. This is
also the practice of Jesu Haly.
The term Nyctalopia is not used by all the ancient authorities in the same
sense. Thus Hippocrates applies it to that morbid state of vision in which
the patient is blind during the day but sees better in the evening. Aetius,
Paulus, and Actuarius, on the contrary, apply it to that state in which the
patient sees clearly during the day but becomes blind in the evening.
On Glaucoma and Suffusion. — Aetius and OribasiHS give nearly the same
account of these complaints as Paulns, and yet that of Aetius seems slightly
different. He says that there are two kinds of Glaucoma ; that the first, to
which the name is properly applied, arises from a dryness and concretion of
the crystalline humour, which is changed to a sea-green (glaucum) colour ;
but that the other arises from a suffusion, the humour near the pupil having
become congealed and dry. Haly Abbas was aware that the disease is some-
times seated in the crystalline lens, but did not know that it always is so«
Hippocrates recommends masticatories and the Actual Cautery. Haly Abbas
and Aisaharavius approve of making trial of remedies similar to those men-
tioned by our author, before attempting the operation. Hhases forbids bleed-
ing when the disease arises from the state of the eye itself. Canamusali, who
flourished about the year 1258, recommends a seton in the nape of the neck
for the cure of suffusion. — De Oculis, lib. vi. Rhases considers the casein-
curable when the pupil has become insensible to the stimulus of light.
On Amaurosis and Dimness of Visioii. — Galen and Aetius give a very cir-
cumstantial account of the causes and tr&itment of Amaurosis. They state that
the disease either comes on suddenly, in which case they refer its origin to ob-
struction and paralysis of the optic nerve, or gradually, when they believe it
occasioned by a thickening of the coats of the optic nerve, or a change of the
spirits or of the humours of the eye. They enumerate various causes of it,
such as injuries of the head, heat or cold, indigestion, or the like. When the
disease occurs suddenly, they approve of general or local bleeding, such as
cupping the back part of the head, and active purging. In the other case
general depletion is not required, but the other treatment is nearly the same,
attention being particularly paid to the state of the bowels. They forbid
emetics after food, but approve of errhines. They recommend in certain
cases sinapisms to the head.
The Arabians treat the disease upon the same principles. Ilaly Abbas de-
scribes amaurosis among the affections of the optic nerves, and recommends
394 COMMBNTARY ON THE THIRI> BOOK.
roc it general bleeding, purging, and the saffron collyrium. Alsaharavius re-
marks that it often arises from the state of the stomach, which, in that case, will
require the principal attention. Avenzoar blames Galen for giving up as des-
perate cases of amaurosis which occur suddenly. He recommends general
and local bleeding, with repellent applications to the head.
On Strabismus, — See Galenus, de Causis Morborum, Gribasius, Synop.
viii. 49.
Avicenna properly remarks that squinting is occasioned by debility or
spasm of some of the muscles of the eye. He and Rhases recommend the
same treatment as our author. Avicenna also makes mention of a mask. Haly
Abbas, who appears to have been intimately acquainted with anatomy, of
which his work contains a valuable compendium, explains minutely the cause
of the disease, which he attributes to an unequal contraction of the muscles
of the eye. — See also Alsaharavius and Jesu Haly. Jesu, like our author,^
directs to fasten a piece of black or red cloth on the angle of the eye at the
temples, when the eye inclines towards the nose. He correctly explains that
the complaint arises from spasms or paralysis of some of the muscles of the
eye.
On Ecpksmus, or Protrusion of the Ei/es. — ^This chapter is taken from Gri-
basius, Syn, viii. 50.
Aetius, Avicenna, and Rhases recommend the same treatment for this com-
plaint, which can only arise from suffocation, violent straining, or swelling of
the eye.
On Synchysis, or Confusion of Sight, — ^Aetius apd Gribasius treat of this
affection in nearly the same words.
Rowley defines Synchysis to be ''a solution of the vitreous humour into a
fine attenuated aqueous fluid.'' It does not appear to me that the ancients
understood it in this sense, or that they meant any thing more by it than a
confiision or disorder of the eye occasioned by a blow.
On Jliyopia.-— This chapter also is taken from Gribasius or Aetius.
Alsaharavius treats of it by the name of Alhayn, He says it sometimes
arises from external causes, such as exposure to snow and cold, in which case
he directs to apply stimulsmt fumes to the eye and refrigerants to the head.
Although the ancients were aware of the magnifying powers of specula (as
appears from Seneca, Quast. Natur,\ it is doubtful if they ever thought of
applying this knowledge to any useful purpose; and hence none of the Greek,
Latin, or Arabian medical authors make any mention of spectacles or magni-
fying glasses as a remedy for this complaint, or for weakness of sight. Dutens,
however, maintains that they were not unacquainted with telescopes.— -P. ii.c
10. From a passage in lamblichus it has been supposed that they also used
microscopes, V, P,c. 26.
Gne of the causes of myopia mentioned by Jesu Haly is enlargement of
the crystalline lens, which he recommends to endeavour to lessen by means
of dissolvents. — De Oculisy ir, iii. c. 6.
XXIII. — ON DI8BASB8 OP THB BAR ; AND, FIRST, CONCBRNING PAIN
OP IT.
The following ancient authors treat of diseases of the ear: — Hippocrates,
de AffectionibuSy et alibi. — Galenus, sec, loc, lib. iii. — Celsus, vi. 7. — Griba-
sius, de Loc. Aff, lib. iv. — Aetius, lib.vi. c. 7A,etseq, — ^Alexander, lib. iii.—
Scribonius Largus. — Marcellus, e^ Mec{. c. 9. — ^Nonnus, c.74. etseq, — Cselius
Aurelianus, de Tard, Pass. ii. 3. — Actuarius, Meth. Med. iv. 10. — Plinius,
if. N. xxviii. 48. — Gctavius Horatianus, i. 7. — Mesne, de Mgt . Aurhum,—
Avenzoar, lib. i. tr. 4. — Serapion, tr. 2.— -Avicenna, lib. i. iii. fen. 4. — Albu-
COUMBNTABT ON TBB THIRD BOOK. 395
casis, p. ii.—Haly Abbas, Theor, ix.l4., Pract, ▼. 62. — ^Alsaharavius, Pract.
tr. iii. — Khases, ad Mansor. lib. i x^ ContinenSy lib. iii.
For relieving Elarach Hippocrates recommends the warm bath and fo-
mentations ; and, when these do not succeed, he directs to use phlegroagogues
and masticatories.
Celsus gives judicious directions for curing pain of the ears, but his treat-
ment is little different from our author's. When the pain is not violent, he
recommends abstinence alone ; but, if severe, venesection, purging, hot cata-
plasms from linseed and fenugreek, or sponges squeezed out of hot water.
When the inflammation is particularly violent, poppies are to be added to the
injections, which must be tepid ; and, when the ear is filled with them, soft
wool is to be put over it to contain the injection. He mentions various com-
pound applications, which contain poppies, castor, myrrh, alum, saffron, and
the like.
Our author copies from Galen. He recommends the following simple ap-
plication : — Having scooped out the heart of an onion, fill it with oil, and,
having heated it in ashes, put it into the ear. I have heard of this as a do-
mestic remedy in Scotland. He gives prescriptions for various injections
and other compositions which are similar to those of our author and Celsus.
Aeticis on this head is more brief and less distinct than our author.
Alexander, Actuarius, and Octavius Horatianus treat of these complaints
very properly, but not differently from Celsus and our author. Alexander states
correctly that inflammation within the ear sometimes spreads to the brain and
proves fetal. Dr Abercrombie relates such cases.— Pa/Ao/ogy of the Brain,
p. i. § 3.
Maroellos gives a long list of empirical applications from which, perhaps,
something valuable might be extracted. He recommends, like some of the
other authorities, a solution of alum in hot vinegar with some honey. We
shall see in the Twenty-sixth Chapter that alum was much used for allaying
the pains of toothach. Among the ingredients in his injections I remark
tepid milk, opium, castor, spikenard, saffron, opobalsam, millepedes, &c.
The treatment directed by the Methodist, Cslius Aurelianus, is little different
from that of the other sects. He approves of putting tepid oil into the ear;
of stuffing it with wool ; of using fomentations, cataplasms, leeches, and sca-
rifications ; and, when the disease becomes chronic, of shaving the head, and
applying acopa, dropaces, malagmata, and so forth.
Serapion and Rhases treat the complaint exactly like our author.
Avenzoar relates a case of inflammation seated in the meatus which he cured
by filling it with oil of eggs. This oil is still used by the peasantry of Scotland
for bums. He further recommends bleeding and the other remedies already
mentioned. Avicenna treats of diseases of the ear most minutely and scien-
tifically, but at too great length for me to do justice to his account of them.
For pains from a hot cause he recommends camphor oil, or oil of violets with
camphor. Mesue also treats of these complaints very minutely. When the
pain is violent, he recommends injections containing poppies, henbane, man-
drake, night-shade, and the like. Haly Abbas in such cases also approves of
rose-oil with opium, the juice of mandrake, &c. Alsaharavius varies his treat-
ment according to the nature of the exciting cause. When it is caused by
congestion of blood in' the organ, he recommends bleeding, abstinence from
wine, a restricted diet, and pouring warm oil into the ear. When it arises
from a cold cause, he approves of oil of costus, of spikenard, &c., and of ap-
plying to the ear a cataplasm of hot flour.
On Ulcers of the Ears — Aetius and Alexander give various prescriptions
for these cases. The fullest account, however, is contained in Galen, sec, he.
When there is a discharge of pus attended with pain, Octavius recommends
alum mixed with honey and oil. When ulcers of the ears are recent, Mesue
396 COMMENTART ON THE THIRD BOOK.
recommends injections of honied water, wine and honey, vinegar and honey,
or the like, by a syringe. They are to be dried by means of olibanura or
sarcocolla dissolved in wine. He also praises myrrh, aloes, alum, and red
arsenic as ingredients in the applications to ulcers of the ears. When the
ulcers are chronic, they are Brst to be cleansed by such applications as thede>
coction of wormwood in wine, or oxymel of squills with a small quantity of.
the flowers of copper; then they are to be dressed with the usual incamants;
and lastly they are to be dried or cicatrised by compositions containing aloes,
myrrh, and frankincense. When the ulcers are foul, he and Serapion recom-
mend escharotics such as the scoria aeris. Ilaly's applications are quite simi-
lar. For sanious discharge he recommends to wipe the ear with a piece of
cloth wrapped round a probe, and dipped in an astringent solution. He directs
to remove fungous flesh by an operation, or with the ointment of flos sris.
In this case Cclsus recommends applications consisting of verdigris and
honey,or frankincense, or squama a ris triturated with red arsenic. These power-
ful ingredients enter into some of the compositions recommended by Rbases.
For Vermes in the Ear, — All the aucieut authorities in this case recommend
acrid and bitter injections. Wormwood, hellebore, nitre, calamint, birthwort,
and sulphur are the common ingredients in the compositions recommended
by Galen, Alexander, Aetius, Oribasius, Celsus, Mesue, Serapion, Haly Abbas,
Alsaharavius, and Rhases.
Tobacco is now generally used in such cases.
On Calculi and the like which have fallen into the Ear, — ^Alexander, Aetius,
and Haly Abbas recommend similar means ; and also direct to compress the
patient's nose and mouth, and to make him sneeze* Galen, copying from
Archigenes, gives similar directions. This subject is more fully treated of
in the Sixth Book.
On Noises, — ^These are fully treated of by Galen, sec, loc. He remarks
that they commonly arise from indigestion, excess of wine, violent vomiting,
or the improper application of medicines to the ear. He says the disease
sometimes arises from excessive sensibility, in which case he mixes with the
injections the juice of mandragora, poppies, or the like. Our author's appli-
cations are taken from Alexander. Celsus treats of this affection very cir-
cumstantially, and modifies his applications according to the circumstances
of the case. He recommends particular attention to the diet, and injections
such as castor with vinegar, oil of iris, or oil of bays, or myrrh and nitre with
roses and vinegar. When local applications do not succeed, Haly states
that the disease is occasioned by an affection of the brain or auditory nerve.
Alsaharavius treats of the complaint with singular precision and at great
length. — Pract. iii. 4.
On Deafness, — On this subject Galen gives copious extracts from Apol-
lonius and Archigenes, from which the aurists of the present day might
derive perhaps some information. In Deafness occurring suddenly he re-
commends fomentations with the decoction of wormwood. Aetius copies
from him. Alexander is very particular about the general treatment, recom-
mending emetics of hellebore, drastic purgatives, errhines, topical applica-
tions, exercise on horseback, change of place, shaving the hesui, and apply-
ing leeches to it, or a sinapism, or using friction, and even opening the arteries.
Celsus properly directs to examine the meatus, and, if any scab of a sore or
sordes appear in it, to inject warm oil, aerugo with honey, or the like ; and
afterwards to syringe it with tepid water. When the sordes is hard, it may
be first softened by an injection of vinegar with a little nitre. Haly Abbas
directs to mix mustard with figs, and apply upon a tent for three days. As
an injection, he recommends castor dissolved in oil of dill, and the juice of
rue. When it proceeds from bile, he recommends hot purgatives and things
of an attenuant nalure. According lo the nature of the exciting cause, Al-
COMMBNTART ON THE THIRD BOOK. 397
saharavius applies Yarious remedies, such as purging, gargles, fumigations
with decoctions of stimulant herbs, detergent oils, such as those of dill,
camomile, &c.
Aaron, one of the authorities quoted by Rhases, states that deafness some-
times arises from congestion of blood about the ear ; and, in that case, recom-
mends local bleeding, and an attenuant diet, with fomentations of hot oils,
and the like. When it arises from obstruction, he directs to use injections
containing hellebore, vine^r of squills, &c.
"For (kmtiuions of the Ears. — Galen gives various prescriptions for this
case. Similar ones occur in Aetius and Oribasius. Modem aurists forbid
to bandage the ears tightly.
On ParotU. — Celsus properly directs that, if the gland swell without any
other disease, applications to produce resolution should be first tried; but,
if the system is labouring under disease, that the swelling is to be brought to
a suppuration, and opened as soon as possible. It is from Galen, however,
that all the subsequent authorities copy their account of Parotis. He lays
it down as an established rule of practice that no attempt is to be made to
discuss the swelling by repellent applications, but that suppuration is to be
encouraged by the proper means. When there is plethora of blood, he allows
venesection; and, when attended with pain, he recommends paregoric cata-
plasms of linseed, fenugreek, camomile, and the like. When any hardness
remains, he directs to use some of the malagmata, or emollient plasters, lie
informs us that Archigenes applied figs boiled and pounded. Octavius
Horatianus and some of the others mention this application. Of the subse-
quent authors, although they contain little additional information, Alexander
may be referred to as one who has treated of the complaint very fully and
judiciously. He recommends bleeding before having recourse to topical
applications.
The Arabians adopt the views of the Greeks. Alsaharavius directs to use
diachylon plaster as a maturative application. When the inflammation
runs high, he approves of bleeding.
XXIV.—- ON DI81CA8B8 OV THB NOSE.
Consult Hippocrates, de Affect, et alibi, — Galenus, de Med, sec- loc,
lib. iii.-* Celsus, vL S.'^-Cfelius Aurelianus, de Mor, Tard, ii. 1. — Oribasius,
Loe. Aff* iv. 45. — ^Alexander, iii. 8.-— Aetius, vi. 90. — Actuarius, Meth, Med,
iv. 12w— Nonnus, c. 92. — Scribonius Largus. — Marcellus, de Med, c. 10. —
Octavius Horatianus, i. 1 1 . — Serapion, tr. ii. — Mesne, de Mgr, Narium, —
Avicenna, lib. iii. fen. 4. — ^Albucasis, ii. 24 — Haly Abbas, Theor, ix. 15.,
Pract, V. 68. — ^Avenzoar, tr. i. 5. — Alsaharavius, Pract, iu — Rhases, ad
Alansor, iv. 45., Divii, c. 40., ContinenSj lib. iv.
Of Polypm4 — Hippocrates describes five species of Polypus. The first
is represented to be like a piece of torn flesh hanging in the nostril, and is to
be extracted. The second consists of hard flesh which fills the nostril, and
is to be treated by the Cautery with the application afterwards of the flos vris
'to the part. The third is a round and soft piece of flesh growing from the
cartilage, and is to be extracted by a ligature, which operation he describes
minutely. The fourth is of a stony hardness, and is to be cut all around
with a scalpel, then burnt, and the part touched with flos teris. The fifth
gprows from the top of the cartilage, and is to be burnt.
Galen gives various prescriptions from Archigenes, Aselepiades, Lampon,
and others, for removing polypus. The most active ingredients in them are
copperas, burnt copper, verdigris, alum, chalcitis, and arsenic. One of the
simplest of Galen*s prescriptions consists of arsenic, quicklime, and white
398 COMMBNTART ON THB THIRD BOOK.
hellebore, which are to be triturated together and applied. Another, named from
Antonius Musa, is a powder consisting of equal parts of arsenic and cop-
peras. I can from experience speak of the good eflects of a similar applica-
tion ; and would, therefore^ wish to call the attention of the profession to this
method of curing polypus. That it may prove dangerous if misapplied can-
not be doubted, but in the hands of a cautious surgeon such an application
will be found both safe and effectual.
Celsus forbids to meddle with the disease when it is of a cancerous nature.
But when soft it is to be cured by an operation. He adds, that it may
sometimes be made to drop off, if touched by means of a tent or pencil with
the following composition : — *' Minii Sinopici, chalcitidis, calcis, sandarachs,
singulorum, p.i.; atramenti sutorii, p. ii.'*^ I need scarcely say that all these
ingredients are powerfully caustic.
Scribonius gives prescriptions similar to those of Galen.
Octavius Horatianus says be has seen the tumour drop off after using such
applications as arsenic with honey.
Aetius gives prescriptions for removing polypus without incision or burn-
ing. One of the most simple of his compositions is a powder composed of
alum, ginger, red arsenic, burnt copper, and galls.
Alexander, like the others, recommends Escharotics, such as misy, cop-
peras, and chalcitis. Marcellus makes mention of the same.
The Arabians imitate the practice of the Greeks. Serapion gives a pre-
scription containing arsenic, copperas, black hellebore, &c. Avicenna de-
scribes the treatment by ligature, extraction, burning, and septic applica-
tions. He prefers the operation. Mesue treats with great precision of (he
different mcMes of cure. When the tumour is not large, it may be removed,
he says, by septic applications. His prescriptions contain arsenic, alum,
flos sris, fcc* Haly says that, when a polypus is hard and cancerous, it is
incurable, but, when soft, it may be removed by applying septic substances,
such as flos seris, arsenic, and the like. Alsaharavius describes the two spe-
cies of polypus, the Cancerous and the Fleshy. For the latter, besides the
operation, he recommends to introduce a thread smeared widi the Egyp-
tian and Green ointments. Several of the authorities quoted by Rhases
approve of the septic applications prepared with arsenic, vitriol, oil of
oleander, alum, and the like.
The ancient method of removing polypus with septics is mentioned by Guy
of Cauliac and other surgical writers of that age. Broen, in his Commen-
tary on the Works of Henricus Regius, gives the following prescription for
this purpose: — 1^. virid. seris, auripigmenti, vitrioli, alum. crud. & &. Jiss.
He says, however, that this method is more painftil than extraction. Manget
rather approves of it. — V. Biblioth. Chirurg,
For Vzana Celsus recommends stimulant and escharotic applicatious
containing copperas, lees of oil, turpentine-rosin, squills, &c. They are to
be applied by means of a specillum or probe wrapped round with wool.
The prescriptions given by Galen from Archigenes and Asclepiades con-
tain misy, chalcitis, burnt copper, orpiment, red arsenic, alum, red nitre^ mjrnfei
saffron, &c. The other Greek authors do but copy from him on this subjecL
Avicenna recommends such aromatics as amomum, cloves, and roses, with
camphor, hellebore, and the like. Haly makes no mention of escharoticf,
but recommends aromatics, such as marjoram, cloves, amomum, myrrh, and
such like substances. He directs to purge with hiera, and to gargle with mm-
tard. The substances which enter into the compositions of Alsaharavius are
very similar to his. The ingredients in Rhases' applications are mostly de-
siccants and aromatics ; but a few of them contain escharotics, such as vitriol
and red arsenic.
The applications directed by the ingenious Mr. Pearson and other modem
COMMVNTART ON THB THIRD BOOK. 399
authorities on surgery are similar to those recommended by the ancients,
namely arsenic, sulphate of copper, eerugo, and the like.
On Ukers.'^-Gsiens prescriptions contain burnt lead, burnt antimony,
ceruse, litharge, and the like. Avicenna and Rhases praise the powder of
Ruffus, which contains alum, galb, cyperus, myrrh, saffron, and arsenic
For tlie Sweet Ulcers AYicenna recommends the same applications as our
author. Those of Haly are nowise different.
Sternutatories* — Similar lists of substances for exciting and appeasing
sneezing are given by Aetius, Nonnus, Avicenna, and others.
On Sleeding at the Nose, — Most of the remedies mentioned in this chap-
ter are taken from Galen, sec. loc. and Meth. Med- Aetius repeats his
directions.
Avicenna has surpassed every other author in the accuracy with which he
details the phenomena and treatment of Epistaxis; but his account istoo
long for me to do justice to it. His local applications consist of styptics,
incrassants, and caustics. He very properly inculcates the propriety of pro-
ducing revulsion and evacuating the general system by bleeding at the arm,
which, he says, should be carried the length of producing deliquium animi.
He directs to apply ligatures to the testicles and extremities, to place the
patient in water cooled with ice, and to pour the same upon his head. He
says a man will lose from 20 to 25 lb of olood before he dies. Haly*s treat-
ment agrees in most respects with that of Avicenna. He directs to pour
water upon the head, to apply to the forehead a plaster of galls, roses, &c.
or a piece of cloth soaked m the infusion of roses cooled with snow and
vinegar. He also makes mention of general bleeding, and the application of
a cupping-instrument to the nape of the neck. Alsaharavius cautions not to
stop a Critical Epistaxis. Like Haly, he recommends, as a general practice,
to bleed from the arm if the strength be good, to apply a cupping-instru-
ment to produce revulsion, to pour cold water upon the head, and to snuff
up the nostrils water impregnated with the virtues of such astringents as
galls, alum, camphor, roses, &c. One of the styptic powders recommended
by Rhases contains quicklime, vitriol, galls, and red arsenic. He also directs
to apply snow to the head. In extreme cases he approves of the Cautery.
Respecting the Manna Thuris mentioned in this chapter, see Bernard's
Nonnus, c. 96. Dale thus explains it: — ^'^ Manna thuris, offic. sunt mics,
fragmenta, pollen, et larina thuris, quae ex coUisione, dum in saccis vehitur,
colliguntur. Alii autem per mannam thuris grana ejusdem intelligunt.'' —
Pharmacol, p. 3&1.
XXV. ON AFFBCTIONS OF THB FACB.
Most of the authors referred to in the precedmg chapter may be consulted
on these complaints.
This chapter is mostly copied from Oribasius (de Loc, Affect, iv.), who,
however, is greatly indebted to Galen. — De Med. sec. loc. Tib. v. Aetius
gives a long list of compositions for these complaints of the Face, and to it
Sie lovers of personal appearance are particularly referred. Celsus seems to
have thought it necessary to make an apology for treating of these trifling
complaints : — *' Paene ineptiae sunt curare varos, et lenticiilas, et ephelidas ;
sed eripi tamen faeminis cura cultus sui non potest.*' His applications are
like those of our author. For vari he recommends equal parts of rosin,
fissile alum, and some honey. Ephelis, he says, is removed by rosin, with a
third part of fossil salts, and a little honey.
One may find plenty of receipts for curing these blemishes in Baptista
Porta, Magia Nnfuralis, lib. ix. Dr. Bateman admits that the ancients were
400 COMMENTARY ON THB THIRD BOOK.
correct ia principle as to the treatment of these diseases, ^ as a gentle stimu-
lus to the skin is the most safe and effectual remedy.'' Instead of those re-
commended by the ancients, he would substitute lotions containing alcohol
with a certain portion of rose or elder-6ower water. When a stronger stimu-
lus is required, \ gr. or 1 gr. of the muriate of antimony may be added to-erery
ounce of alcohol. — On Cutaneoiu Diseeues, Ord. 7.
The <l>aKO£ and *€<^Xif are, I believe, the Lentigo and Macula of Haly Abbas.
^"Theor, viii. 18., Prart. iv. 15. His remedies consist of bitter almonds, mer>
cury kUkd (sublimed ? ), mustard with the oil of figs. The lavOoi is his mo-
rum. For ithe recommends the flosferis and otlierstimulantapplications. Alsa-
faaravius speaks of the juice of the wild cucumber, the root of iris, pine gum,
and, if these are not sufficient, venesection. He treats minutely of these affec-
tions of the face. — Fract, tr. vi. The uivOos is the Acne of Drs. Willan and
Bateman. Galen says these affections are to be removed by emollient and
discutient applications in general. He treats very fully of hypopion or ecchy-
mosis of the face For it Alsaharavius recommends an application consisting
of the infusion of radish and red arsenic. — Fract, vi 4. This must have been
a powerful stimulant. Marcellus recommends to apply frequently a new
sponge soaked in hot salt water. — De Medic, c. xix.
Rhases describes this affection by the name o^pannm faciei. Among the
ingredients of his compositions I remark fenugreek, ammoniac, frankincense,
liquid pitch, &c. Some of them contaiix arsenic. He also recommends scari-
fications.
XXVI.— ON AFVECTIONS OF THB PARTS WITHIN THE MOVTH.
All the authors referred to in the twenty-third chapter may be consulted.
On the Teeth.'^-G^Xe.n in particular deserves to be consulted on diseases
of theTeeth, which he has treated of very fully in the Fifth Book of his Work,
de Med, sec, loc. He very properly combats the opinion, which we still
sometimes hear maintained, that the teeth themselves are devoid o! sensibi-
lity. He states that once having toothach he felt his tooth not only pained
but throbbing. One of the best of our modem writers on the teeth, £u&tachius,
justly remarks that the teeth have a nerve of considerable magnitude distributr
•ed upon them, and are in fact possessed of exquisite sensibility. When the
teeth ache, Galen says the strongest medicines are. indicated, in order to repel
and discuss the exciting cause. Most of these are to be prepared with acrid
vinegar. He then gives from Archigenes a long list of compositions for allay-
ing the pain of toothach, from which most of those mentioned by our author
are taken. One of the articles which most frequently occurs in them is alum,
a solution of which in the spirit of nitre was lately much cried up as a«cure
lor toothach. Of the great number of substances recommended to be put
into the hole of the carious tooth, it is difficult to form a judgment, as most
of them are now never tried in such cases. Some of them seem plausible
applications. One consists of pellitory with myrrh ; another of opium and
pepper; others contain ginger, poppy juice, hyoscyamus, galbanum, castor,
occ. He approves of hot fomentations, and of the heated flour of barley or linseed
applied to the cheek. He speaks favourably of filling the hole in the teeth
with hot wax. When part of a tooth projects, it is to be filed down with an
iron file. For pains of^ the gums he recommends fomentations with vinegar
in which henbane has been boiled. Of dentifrices he has treated at conside-
rable length, and it is from him that our author takes his list.
Scribonius Largus mentions alum among his remedies ; and T may remark,
by the way, that this medicine is recommended for toothach by many of the
earlier modem authorities. — V, Guido de Cauliaco, vi. d. 2.
OOMMBNTART ON THB THIRD BOOK. 401
CeUus deltYers very judicious instructions for the treatment of toothach.
He circumscribes the use of wine, enjoins restricted diet and food which
does not require mastication ; then fumentations of hot water by means of
sponges are to be applied to the tooth, and so forth. If the pain is more
violent, the belly is to be opened, hot cataplasms applied, and some warm
liquid retained in the mouth, and often changed. The liquid may be a de-
oodioQ of some narcotic, such as poppies, raandragora, and byoscyamus. He
praises hot oil applied by means of a probe wrapped round with wool* He
also mentions compositions containing peHitory, alum, bitumen, and imi»-
tard. He directs not to be in haste to extract <he tooth.
Aetius gives a variety of applications for removing 4eeth without an ope-
ration. iJue of them contains red arsenic ; another son and the juice of
spurge. Modem dentists are ig^norant of such remedies. His account of
the nerve which supplies the teeth with sensibility is accurate but borrowed
from Galen.
Octavitts Horatianus, -like our audior, affirms that the juice of spurge (tithy-
mallus) will make the teeth fall out. For the same purpose he likewise praises
the. powder of pellitory and mugwort. After Hipprocrates he approves of
the application of small bags containing salts or millet.
The medicinal substances recommended by Marcellus, tiie Empiric, are
the same as those already mentioned. He praises strongly a composition
consisting of acrid vinegar, alum, and cedar rosin, boiled to the consistence of
honey and applied to tlie carious tooth. To prevent hollow teeth from fall-
ing out he directs to fill the hole wiith the gum which grows upon the ivy.
The juice of poppies pounded in a «voKian's milk and applied to a carious
tooth is said to remove 'the pain instantly. As a dentifrice he recommends
finely-powdered glass with spikenard.
Cslius Aurelianus recommends abstinenoe, vest, and i-insing the mouth
with some astringent decoction oontaining white poplar, mandragora,
poppies, henbane with vinegar, hot oil, milk and honey, and the like. He
applies bags containing hot flour. If the pain does not abate, venesection is
to be had recourse to, a cupping-instrument applied near the afiected part,
and the belly opened afterwards by a clyster. Sometimes the gums are to
be scari6ed or separated from the teeth by means of a scarificator. Respect-
ing anodyne medicines, he remarks that they diminish sensibility but do not
rraaove pain. He says, like >tbe <other authorities, that the juice of the tithy-
mallas, or spurge, breaks the teeth — *^ dentes infringit." He disapproves very
much of early extraction, and mentions that Herophilus and Ueraclides of
Tarentum relate cases of persons who had died in consequence of this opera-
tion. A similar ease occurred in a London hospital about fifteen years ago..
He says that in the temple «f Apollo at Delphos there bung a tootlirextractor
of lead, which was meant as a hint not to exert great force in extracting
teeth. For bleeding of the gums he reoonmeads alum with honey, and the
like.
SerapioB, like the Greek authorities, mentions a variety of remedial means
for diseases of the teeth. One of bis prescriptions consists of burnt alum,
with ^rinegar, salt, and sumach. When the pain is violent he dicects to fill
the hole with opium or some other narcotic. Avicenna recommends general
bleeding, the application of leeches to the gums, opening the Ranal veins, and
cupping below the chin. His compositions contain opium, burnt alum ex-
tinguished in vinegar, galls with vinegar, and the like. He mentions the
juic^ of tithymalhis, and several other substances, as possessing the property
of making the extraction easy.
Avenzoar recommends in particular bleeding from the Ranal veins. Mesue's
general treatment is very judicious, but similar to that of our author and the
others. He also makes mentionof alum and vinegar. He says that some apply
D d
402 COMMBNTARY ON THB THIRD BOOK.
the Actual Cautery to the tooth. Haly directs to heat two aeedles red hot, and
then, haying dipped their extremities in oil, to burn the hole of the tooth
with them. He recommends to fill the hole with a composition consisting
of pellitory, sal ammoniac, opium, and wax. Some of his applications con-
tain arsenic. That this article would deaden sensibility, and might destroy
the vitality of the diseased parts, I can readily suppose, but of course it
would require to be used with extreme caution. Certainly not more than
2 gr. should be used, and every precaution ought to be .taken to prevent the
patient from swallowing his saUva. Haly, lUce most of the others, makes
mention of alum. Alsaharavius recommends general bleeding, cupping,
scarifications, and leeches ; then warm vinegar, or some warm anodyne in-
fusion, is to be beld in the mouth ; or the part fumigated vnth the vapour of
water in which opium, camphor, or henbane have been boiled. He speaks
also of the Actusil Cautery. Rhases recommends bleeding, cuppii^, alum
in vinegar, opium, henbane, &c.
The dentifrices and applications to the gimis recommended by the Arar
bians are similar to those of the Greeks. See in particular Haly Abbas,
Fract, V. 78., Rhases, Cont, lib. v. and Alsaharavius, Pract, tr. viii. 2.
Like our author's, theirs contain such astringents and aromatics as balaostine,
sumach, galls, spikenard, wild mint, cinnamon, salt of gem, and the like.
The pumice-stone in particular was much used for this purpose ; but, as Dr.
II ill remarks, it is apt to hurt the enamel.
Sprengel treats as ridiculous the opinion entertained by the ancient physi-
cians and those of the middle ages, that certain applications will make the
teeth fall out without pain. — Hist, de la Med,
On Ranula. — Aetius, Actuarius, and most of the other authorities recom-
mend similar applications. They consist of astringents and escharotics.
Avicenna calls the Ranula an enlargement and induration of the sublin-
gual gland. He approves of nearly the same treatment as our author. He
recommends in particular burnt vitriol and hermodactylus with the white of
an egg. Alsaharavius directs to use, in the first place, applications contain-
ing nitre, sal ammoniac, and the like. If these do not succeed, caustics are
to be applied, so as to occasion a blackening of the part If this does not
answer, an operation must be performed. Rhases msikes mention of an ap-
plication containing ^reen copper, vitriol, &c.
For an account of the manner in which the veterinary surgeons treated
ranula in cattle, see Columella, vi. 8., and Vegetius, Mulom. iii. 3. They re-
commend to open the tumour and apply to it stimulants, such as ^^ic
pounded with salt.
The disease which Hippocrates describes by the name of {moykwrvts ap-
pears to have been somewhat different from the one we have been treating of.
The hypoglottis of Hippocrates was an inflammatory swelling of the tongue
ending in abscess. When matter forms, he directs to open the abscess. I
have seen several cases of it. It is also described by Aretsus.
Ambrose Par^ recommends to open the ranula with a heated instrument.
Munnicks, however, agrees with Fernel, that it may be opened safely with a
common scalpel. Some, he adds, preferred making an opening by passing
a needle armed with a thread through the tumour.-— In Chirttrg.
For Inflammation of the TonsiU and of the Uvula, — Since, as Galen re-
marks, the same treatment applies to Inflammation of the Tonsils and Uvula,
we shall treat of both together.
Aretsus has described inflammation of these parts with great accuracy and
minuteness. He has also given a very circumstantial account of the ulcen
which occur there. Some, he says, are common, mild, and not dangerous;
others are uncommon, pestilential, and fiital. The latter are described as
being covered with a livid or black crust. The ulcer, he says, is apt to spread
COMMRNTART ON THE THIRD BOOK. 403
to the tongue, or it passes down the Trachea and proves fatal by occasioning
suflbcation. The disease, he says, is brought on by cold acrid substances,
and sympathy with disease of the stomach or lungs. Children are most
subject to it. It is endemial in Syria and Egypt He gives a striking de-
scription of death occasioned by suffocation. With regard to the treatment,
when the parts a«e iniiamed, swelled, and threaten suffocation, he advises
copious bleeding fW)m the arm, acrid clysters, purgatives, ligatures to the ex-
tremities, astringent and emollient applications to the parts, cupping the
hind-head or breast, and other such means. Respecting the pestilential
ulcers, when attended with inflammation and sense of suffocation, he ap-
proves of clysters, venesection, gargles, fomentations, ligatures to the extre-
mities, cupping, and so forth. When the disease is spr^uling, he directs to
bum the sore with powerful caustics, such as alum with honey, chalcitis and
the hk€. Sometimes, as he remarks, the Uvula and parts there are eaten
down to the bone.
Galen gives a long and very interesting account of these ooropUdnts inter-
siixed with curious extracts from Archigenes. Their general treatment con-
sists of venesection, acrid clysters, and purgatives. T^eir local applications
are mostly of an acrid and austere nature.
When the tonsils suppurate, Aetius directs to open the abscess. He gives
an interesting description of pestilential ulcers, which, however, is not very
different from that of Aretsus. He approves of bleeding at the arm, suppo-
sitories, clysters, ligatures to the extremities, and so forth. The subsequent
Greek authors follow him acid Galen in their descriptions.
Marcellus, the Empiric, recommends for swelled Uvula various escharotic
applications containing chalcitis, flos sris, alum, and the like.
Celsus delivers a brief account of ulcers of the internal fauces. He speaks
in rather equivocal terms of warm cataplasms, fomentations j and fumigations;
but is, upon the whole, inclined to permit the use of them if there be bo dan-
ger of oold afterwards. He very properly forbids to irritate the parts. He
^es not approve much of gargles of vinegar, although recommended by Ar-
jchigeoes, whom he calls ^ muHarum rerum auctor bonus.** He prefers
«iBollJent gargles at first, and afterwards repellent ones.
The Arabians treat inflammation of these parts like the Greeks. Avioenna
follows closely >our author's plan of treatment. Mesne approves of bleeding,
clysters, and so forth. Rhases mentions bleeding and gargles with vinegar,
the water of roses, and other astringents. In inflammations of the Uvula,
Haly Abbas recommends general bleeding, gentle purgatives, and astringent
gargles containing alum, pomegranate flowers, sal ammoniac, and ihe like ;
and, when these do not succeed, he advises to have recourse to the operation
^See Book Sixth). Alsaharavius recommends a plan of treatment perfectly si-
milar, and, like Haly, directs to have recourse to excision when other remedies
fail. Alexander Aphrodisieus says, howev^, that those who have had the
Uvula cut off die of -consumption ; and attempts to account for the operation
having this effect. — ProbL ii. 3.
Avicenna and the other Arabians make mention of the amulet recom-
mended by Galen.
XXVII. — ON STNANCHE.
See Hippocrates, de VictuAcutorum,c, 39,fdeProgno8.fde Morbis, lib. ii.
and lib. iii. — Galenus, de Med. sec. loc. lib. vi., de Loc, Affect, lib. iv. —
Aretsns, de Morb. Acut. \. 7. — Alexander, iv. 1. — Aetius, viii. 48. — Oriba-
sius, Morb. Curat, iv. 71.— Actuarius, Meth. Med. iv. 14. — Celsus, iv. 4.—
Nonnus, c. 123.— Scribonius Largus, c. 16. — Caelius Aurelianus, Morb.
Dd2
404 COMMBNTART ON THE THIRD BOOK.
Acut, iii. 1. — Octavius Horatianus, ii. 6. — Marcellus, de Med. c. 15.- — Sera-
5 ion, ii. 18. — Avicenna, lib. iii. fen. 9. — Mesne, de Mgrit, GutturU. —
Lvenzoar, lib. i. tr. 10 — Haly Abbas, Fract, i. 26., and Pract, vi. 2. — Alsa-
haravius, tr. xi. 2. — Rhases, ad Mansor, ix. 54, and iv. 25, and Continent,
lib. vii.
The plan of treatment recommended by Hip{>ocrate8 can scarcely be im-
proved upon : — General bleeding, opening the veins below the tongue, giving
warm gargles and linctuses, shaving the head, wrapping the neck in soft
wool, or applying fomentations to it, giving honey ana water, or ptisan not
cold, and administering clysters or purgative medicines. According to Le
Clerc, he performed Bronchotomy in extreme cases. He refers, I suppose,
to lib. iii. c. 11. de Morbis, but the language is not so precise as to make it
quite certaiu that Bronchotomy was there meant to be described. Sprengel
supposes that he only introduced a tube by the nostrils into the Trachea.
Aretsus states that the parts affected with Synanche are the tonsils, epiglot-
tis, fauces, uvula, the upper part of the Trachea, and, if the inflammation
spread, the tongue and jaws. He makes a distinction between Cynanche
and Synanche. The former is attended with swelling of the parts and other
well-known symptoms, of which he has given a striking description. In
Synanche (which he attributes to the Pneuma being overheated and over-
dried), the parts, on the contrary, are contracted, and there is a strong sense
of suffocation. This disease, he says, generally proves soon fatal, unless
swelhng and inflammation of the parts supervene, or erysipelas of the breast
occur ; in imitation of which, he states that a good physician will apply a
sinapism or cupping-instrument to the chest to produce revulsion. In treat-
ing the formei variety of the disease, he begins with administering two clys-
ters to evacuate the bowels and produce revulsion ; he bleeds in the arm from
a large orifice so as iiearly to bring on deliquium anirai, and he approves
also of bleeding by opening tlie veins below the tongue: he recommends ap-
plications at first of an astringent nature, but, if suppuration be expected, he
directs hot ones from fenugreek, hot fomentations, sponges squeezed out of
.the decoction of bay or hyssop, and the like. In the other variety, he re-
commends to determine outwardly by all possible means, such as by appli-
cations containing nitre, mustard, 8ic. He mentions that in this variety some
were said to have opened the wind-pipe, in other words to have performed
Laryngotomy. He does not believe, however, that the operation had ever
actually been performed, and dissuades from attempting it, as it would only
increase the evil ; and he apprehended that the wound in the cartilages would
never heal. From his account of Synanche Le Clerc concludes that
Aretaus belonged to the Pneumatic sect. By Pnewiia was probably meant
the vital heat and gases in the body.
Celsus, like Areieeus, describes the two varieties of the disease, and recom-
mends nearly the same treatment.
Galen and after him Aetius give a similar account with great minuteness
and precision. I cannot pretend to do justice to their treatment ; and shall
merely mention that, in the second variety, they praise mustard for a gatgle,
and elaterium as a purgative.
Alexander's directions are most minute and judicious, but I must be con-
tent with stating that he approves of opening the Ranal and Jugular veins, and
that his treatment is otherwise similar to that of Galen. This is the first men-
tion of opening the jugulars.
Octavius Horatianus I shall merely mention in order to state that he has
described the twg varieties of the disease like the others*
Cslius Aurelianus gives a singularly accurate and circumstantial account
of this disease, but it is so long that I can merely afford room to point out
a few of his leading opinions. He approves of a fomentation made with a
COMMENTARY ON THE THIRD BOOK. 405
bladder half filled with hot sweet oil. He directs to inhale the steam of hot
water, and to apply sponges squeezed out of it to the neck and throat. He
approves of capping: the neck or of leeching it, and also of scarifying the
tongue and fauces if they are much swelled. With respect to the treatment
of the other sects, he blames Hippocrates for making too rapid a detraction
of blood, and also for opening the veins below the tongue, which, he says,
will only aggravate the evil, and may be productive of inconvenience owing
to the difficulty of stopping the bleeding. But, in particular, he finds fault
with Archigenes for mentioning Laryngotomy, and treats the operation as en-
tirely fobulous and the fiction of that physician. His aversion to it is so
strong that he pronounces it a crime. Before having done with this author,
I may remark, that Prosper Alpinus, the modem advocate for ancient Me-
thodism, does not agree with Caelius in condemning the Hippocratic practice
of opening the veins below the tongue. In his own case he nad experienced
the good effects of this practice. — Med, Meth. vii. 10. It is also recommended
by Sydenham ; and, although not now in general use, I myself have practised
it with good effect.
The Arabidns, like their Grecian masters, describe the two varieties of the
disease, and treat them accordingly. For the variety called Synanche by the
Greeks they approve of hot gargles consisting of mustard, pepper, and the
like. This resembles the modern practice of using gargles of Cayenne pep-
per. In the following passage, Rhases evidently points at the Contagious
Synanche : — ** It happens on certain years in spring that a bad and destruc-
tive species of Synanche attacks a great many persons. Wherefore at such
a time it will be proper to anticipate the disease by venesection, abstracting
blood from the legs with cupping-instruments, opening the belly, and gargling
with rose water, or infusions of sumach, mulberries, and nuts.'' Haly Abbas
likewise states that the disease is sometimes epidemical. Rhases approves
of general bleeding, of opening the sublingual veins, and of using astringent
gargles at first, and afterwards maturative ones consisting of figs, sweet al-
monds, and the like. In his Continens he seems to allude to Bronchotomy.
Alsaharavius describes the two varieties of the disease with great minuteness.
He agrees with the others as to the danger of that variety in which there is
no swelling nor inflammation outwardly. Avicenna and other of the Ara-
bians follow Alexander in recommending bleeding by opening the jugulars.
The two kinds of Angina mentioned by the ancients are described in similar
terms by Sydenham, Boerhaave, and Van Swieten. The first variety, or com-
mon quinsey, is well known. The second is of less frequent occurrence,
and generally supervenes upon long-protracted fevers and great evacuations.
The modem authorities have found it as fatal as the ancients gave them reason
to expect. The reader will find a very interesting commentary on Aretsus'
description of malignant sore throat in a tract, de Recondita Abscessuum JVia-
tura. V, Mangeti Bibl. Chirurg, t. i. p. 48.
Our author's remedy for suspended animation is probably as efficacious as
4he application of salt to the tongue lately recommended by Dr. O'Meara.
Haly approves of the same treatment. In treating those who have been in
water, he directs, very improperly I am convinced, to suspend the patient
by the heels, to favour the escape of the water by the mouth. It would ap-
pear, however, from the late experiments of Professor Meyer, that the ancients
were correct in supposing that Avater is generally found in the lungs of
drowned persons. When a person has bung by the neck for a time, and
there is any prospect of recovery, Haly directs, as soon as he can swallow, to
make him gargle with oil of violets and tepid water, and to drink barley-
gruel and Ae like.
406 COUMKMTARY ON THE THIRD BOOK.
XXVIIL— ^ON COHYZA, CATimaH, AND COUGHS.
All the writers referred to in tlie preceding chapter (with the exception of
Aretxus) may be consulted here.
Galen, in the 7th book of his work, dt Med. sec. loc. lias treated of these
diseases so fully that he may be said to have exhausted the subject. I ca&
only afford room for a few of his general remarks. He states that the Arteriacs^
or compositions for affections of the Arteria Trachea, consii»t of three diflerent
kinds of medicines. First, those called by him Obstrnenis, and answenng, I
think, to those now called DeHMilcents, such as Cretan sweet wine, traga^*
canth, liquorice, and the like, which act by smoothing the asperities of the
parts. Second, the Acrid, containing cinnamon, turpentine-rosin, and the
like. Third, the Intermediate, consisting of the juice of ptisan, almonds, and
the like. He gives a great number of compositions from Andxomacbus, Cvi-
ton, and others, which might deserve attention. Of their ingredients some
are Expectorants, such as squills, myrrh, &c. ; some DemB4<^enis, such as
liqucMrice, tragacanth, &c. ; and some Narcotic, such as opium, mandragora,.
hyoscyamus, and hemlock. With the mediciaal properties of the last-mentioned
article (I mean the Conium maculatum}, which Dr. Paris commends so highly
ill diseases of the chest,, the ancients were sufficiently well acquainted. For
humid Coughs Galen recommends a composition of alum, opium, galbanum,
and storax. He mentions Lumbrici ia the Stomach as a cause of coughs. —
(Com. in Epid. iii.) Among the remedies mentioned by our author, by
Galen, and by most of the ancient authorities, we may remark l^e inhaling the
fumes of certain acrid medicines, such as yellow orpiment, and sandaiach, or
realgar^ i. e. red orpiment. Whether the practice be safe or not I shall not
pretend to determine ; but, unquestionably, it is recommended upon high
authority ; and, therefore, the following account of the matter, given by Dr.
Paris, is incorrect : — *'' Strange as it may appear, Artenk has been inhaled to-
gether with the vapours of frankincense and those of other gums during a
paroxysm of Asthma ! This extraordinary practice arose from the practi-
tioner mistaking the gum juniper, or Vermx of the Arabians, which, by their
medical authors, wa» prescribed in fomigations, under the name of Sanda-
iach, for the Soi'dapcHnf of Aristotle, which was a sulphuret of Arsenic." —
Pharmacologia, t. ii. in voce Arsenic. I refer Df. Paris to Aetios, viii. 61.—
Pseudo-Dioscorides, Euporist. ii. 33. — Plinius, H, N. xxxiv. 55. — ^Alexan-
der, ▼. 4. — Myrepsus, § xli. c. 76^— Secapion,. tr. ii. 19 and 24. — and Rhases,
Cont. lib. viii. The ancient veterinary surgeons used Arsenic in fumigations
for the coughs of cattle. — See Vegetius, Mulom. iii. 6-7. Plateariiis, a OMh
dern writer of the 13th century, recommends Arsenic iw Chronic Coughs^
both in fumigations and taken into the stomach, and yet he disttngiiisiies
quite correctly the Sandarach, or Red Arsenic, from -the Gom Vemix. — Dt
Sintplici Medicina. Some of the earlier writers on the venereal diswoe re-
commend fumigations with Arsenic for syphilitic ulcers of the throat.-— V.
AphrodisiacuSy and Chap. Twenty-ninth of this Book.
At the commencement of a common Catarrh, Celsus advises to abstain
'< a sole, balneo, vino, venere ;*' but to use ** unctione et assneto cibo.*' When
the lungs become affected, he recommends much friction and exercise on
foot. He gives the following account of the origin of these complaints: —
'*• Distillat autem humor de capite interdum in nares, quod leve est; inler-
dum in fouces, quod pejus est ; interdum etiam in pulmonem, quod pessi-
miim est/' The idea of the disease originating in the head and spreading
downwards prevails in all the ancient descriptions of the disease. — See, in
particular, Aetius, wiio copies, however, in part from Galen.
COMMBNTARY ON THE THIRD BOOK« 407
Alexander devotes a whole chapter to the consideration of tliese com-
plaints. He forbids diuretics, because they carry off the thin part of the
humours and leave the thick beiiind. Respecting the Chalazia mentioned
by Galen, and ** the smooth, hard, and firm stone" said to have been ex-
pectorated by Alexander's patient, I shall merely remark that, as both these
authors were men of undoubted veracity, their narratives are entitled to all
credit. A few years ago, I attended a man affected with a Chronic Cough, who
at length expectorated a< substance resembling bone, of the size of a common
nut. Plater relates a case of Asthma produced by pulmonary calculi. — Ob'
tervat, lib* i. See also Sprengel, HUt. de la Med, § ii. c. 3.
The treatment recommended by the great Methodist, Cslius Aurelianus,
ia DOl much different from the practice of the other sects, only he enjoins a
more rigid abstinence from wine and food of a heating nature. He also
condemns the practice of inhaling the vapours of red arsenic (sandaracha),
and the like. In protracted cases he recommends a change of place.
There is nothing original in the practice of the Arabians. Avicenna pru-
dently directs not to use preparations of poppies after expectoration has
commenced. For Coryza Haly Abbas recommends, if the patient's age and
temperament permit^ bleeding, a spare diet, abstinence from wine, fumiga-
tions with the vapours of camphor, lignum aloes, vinegar, &c ; avoiding to lie
on the back, and so forth. He treats at great length of Coughs, distinguish-
ing them according as they are seated in the throat, gullet, or lungs, and
whether they be sympatlietic or not. For Hoarseness, he directs gargles from
the seed of anise or fennel, or a decoction containing radishes, parsley, fen-
nel, roastich, spikenard, iris, figs, &c. Alsaharavius treats fully of these
complaints in much the same terms.
XXIX. ON ASTHMA AND ORTHOPNGKA.
The following ancient works may be consulted : — Hippocrates, Aphoris,
— -Galenus, de Clomp. Med. uc. he. lib. vii.— Celsus, iv. 4. — Aretsus, Morb.
ch.im 11. — Cselius Aurelianus, Morb. Turd. iii. 1. — Aetius, viii. 63. — Ori-
basius, Loc. Affect, iv. 79. — Actuarius, Meth, Med, iv. 4. — Marcellus, de
Med. c. 17. — Nonnus, c. 127. — Octavius Horatianus, ii. § 2. c. 12.= — Sera-
pipn, ii. 24. — Avicenna, lib. iii. fen^ 10. tr I.e. 38. — Mesne, de Mgrit. Feci.
— Haly Abbas, Pract. vi. 8., Theor, ix. 20. — Alsaharavius, FracU viii. 5*-^
£haaeS) ad Mansor. ix. 56., Continent, lib. viii.
Our author's theory of the disease is borrowed from Galen, and seems
very plausible. It being admitted by our best modem pathologists, that
there is uo organic alteration of structure in ordinary cases of Convulsive
Asthma, it seems likely that the paroxysm is occasions by thick and viscid
humours infarcted in the lungs ; or, most probably, in many cases from the
mtem being loaded with such humours which nature casts off by the lungs.
GmleDylike our author, maintains that the use of attenuant and detergent me-
dicines is indicated. His internal remedies are squills, pepper, wormwood,
opoponax, storax, sulphur, oxymel, millepedes, &c. He forbids all things
which are either of a very hot or cold nature, as in either case tliey tend to
thicken the humours.
Aetius gives nearly the same account as our author, both having evi-
dently borrowed from Galen. He strongly praises vinegar of squills, myrrh,
pepper, and the like. In certain cases he advises to apply the Actual Cautery
to the head (see Book Sixth, c. 1 .), under the impression that the disease is
occasioned by a defluxion from it. He also speaks of burning the chest in
several places for the purpose of making issues ; and further recommends
strong rube&cients.
408 COMMBHTAET .OK THK TBIEB BOMi.
Aretseus give^a good description of the symptoms of the disease, whieh^he
attributes to a humid^ thick, and glutinous materiel in the lungs. His chapi-
ter on the treatment is lost.
. As Oribasiusy Actuarius, and Nonnus, follow the principles laid down bj
Galeu, I need sot give any acco«nt of their opinions.
(>ctavi«s Il^ratianus adepts Galen's theory, which be thus explains:-^
'' Fingui autem et frigido phlegmate pulmotiibus adhcrente, caverne,'Vel
meatus, quibus nataraliter spiritus redditur et aceipitar, concluduntur; et
ex hoc impediraento suspirium, vel anhelitus melestissimus, nascitur, ut se-
dendo magis quam jacendo respitet.** Ue reo^mmends bleeding, if not
contra-indicated ; but, if that is the case, frequent abstinence. Among his in-
ternal remedies 1 remark oxymel, gum ammoniac, castor, and vinegar of
squills. lie approves also of emetics.- lie directs to use stimulant applica-
tions to the ehest, also fomenta^ons and sinapismsr A Wng joarae^Fy be says^
is bene6eial.
The first article raeationed by MaiceUas,. the En^iric, among hi» remedies
for Asthma is vinegar of squills.. Almost all the ancient authorities praise
the virtues of squills in this-disease.
Cselius Aurelianus disapproves of burning the head and of strong purging,
lie approves of bleeding, ii the patient's strength permit, of clysters, cupping
^e breast^ gestation, friction, vociferation, emetics from radishes, or even
from hellebere, and of giving the vinegar of squills. lie speaks favourably
of the cold bath.
Serapion recommends friction, exercise, squills, fumigations with arsenie,
'&C. Mesne also recommends arsenic in various forms. AviceiiBa^a account
is particukirly full and judicious. He pioperly remarks thai Asthma i»
sometimes connected with derangement of the head, liver, and stomach. I
have often seen Asthma arising from disorder of the stomach. Like the
others, he approves of arsenic, both in pilte>and in solutioo.^
Haly Abbas, like Galen, refers Asthma to a collection of gross phlegm
about the cells of tlie lungs. His remedies are of an attenuant and iscisive
.ttattfe, and he particularises the vinegar of squills. Heea«tioiis Asthmatics
to beware of indigtstion, and, therefore, forbids exercise after food, buH recom-
mends it before a meal. After exercise he enjoins hard friction, no
doubt with the intention of favonring the cutaneous perspiration. Ukases
.commends squills and the tepid bath, like the othen, he approve* of in>-
hahng the vapours of arsenic.
Vegetius, the veterinary surgeon, reeommends sqoill» with wine, assalstida
and oil, for these complaints in cattle.
Respecting the use of arsenic in Asthma, Prosper Alpinvs leiiiarks:^—
*' Prsterea audent aliqui arsenieum summ^ exitiale venenum illi» exhiberer
Narrant quadam nepotem patfis fratri deerepito orlhopooico, ut eum interi-
meret, clam in fereulo ex cucurbiti parato porrexisse arsenicnm',- eeque non
mode non interimisse decrepitum, verum et ab asthmate prorsus seaaase.'* —
De Meth, Med. x. 13. He states further,. by the way, both ia that work and
in tlie one de Medicina JEgypt'wrumy that the Egyptians were in the practice^
for the cure of Asthma, of applying cones of cotton to the breast, vdA setting
them on lire. This resembles the moden> method of burning witb aiexa.
Georgius Agricola recommends the arsenical bath in casee c^ Asthma. —
Auctores de Bmineis, p. 279. Theodoras de Mayeme, physician to Charles
I. of England, directs to inhale the fumes of tobacco, hyssop, arsenic, &c.
for Asthma and Dyspnsea. — Mangeti, BihL Scrip. Med. t. ii. p. 283. Fra-
castorius, who recommends this practice for contagious phthisis, speaks of it
in the following terms : — ** NonnuUi antiquorum jubent Sandaracae nidorera
per anhelitum in puhnoues tralii ^ quam autem Saodaracam dico, non earn
intelligi volo quje vernix vulgo vocatur, sed quee auripigmentum a nobi^
COHMKNTART ON TBB THIRD BOCMC* 40d
dieiior : porro nee per auripigmeDtum velim a te accipipriorem illam speciem
oiiae cilrina est sed aiteram, qu» est ruffa^ et propria Sandaraca vocatur.'* —
Morb. CorUag. lib. iii.
Dr.. HilH fto«v«Ver, properly remarks that the arsenic of the ancients, or
orpiment, was a much more innocent substance than the factitious arsenic of
Ihe modems, and the Sandaracfo must have been more sow — See also Cleave-
knd a Mineralogy, p. 680.
XXX.^ — ON FNEVMON&A,
The reader is referred to the authorities on Pleurisy, as several of them
treat M both diseases togedier.
Hippocrates reccmimends bleeding, purging, and attenuant drinks.
Aretvus gives^ a minute and faithful account of the dbease, but his descrip-
liofi is too long f(Mr my limits. He remarks that, as the lunes have but small
nerves,.tbeie is> little paki unless the investing membrane be affected. He
states tliat, when the suppuration takes place, a metastasis of the matter to
the bladder ot belly sometimes occurs and relieves the patient, whereas, if it
is determined to the lungs, it is apt to terminate in phthisis. He gives ex-
cellent dicectiona for the application of his remedies, which are the same as
those now in use, namely, copious bleeding (but so as to avoid deliquiuro)^
purging, attenuant and diluent drinks, rubefacients containing mustard to
the chest, and so forth.
- Aetius makes the same remark as Arebeus respecting the metastasis of the
mutter. His account of the disease is excellent, but like our author's.
Cebiis properly states that the danger is greater than the pain. His ac-
count of the treatment is too long for my limits, but is well deserving of at-
tention.
A» the Arabians treat the disease like the Greeks, it is unnecessary to say
amch of their practice^ UaJy Abbas describes the disease as a hot inflam-
-matitm of the lungs, for which he recommends bleeding, cooling and diluent
.dtaugfats, containing linseed, fenugreek, barley, oil of almonds, liquo-
.ncey'fibC.
Rhases describes a .<{pecies of Pneumonia requiring the use of tonics, ana-
iepticsy and win«. He relates Ihe case of a patient wlio, he affirms, would
infallibly have sunk under this disease, if he had not resisted the advice of
the other medical attendants who prescribed the anti-inflammatory treatment
aud laxativesw
XXXI.— ON SPITTING OF BLOOD.
See Hippocrates, dt MorbU et alibi. — Galenus, Meth, TherapAih, v., and
•■•cr. foe. lib. iv. and vii. — Areteeus, de Morb, Acui, ii. 2.— Aetius, viii. 65, —
Celsus, iv. 5. — Alexander, vii. 1. — Oribasius, ^nop. ix. 2. — ^Actuarius,
Metk, Med. i. 17. — Octavius Horatianus, lib. ii. p. 2. c. 9. — Nonnus, c.
128. — Scribonius Largus, c. 83. — Marcellus, de Med. c. 17. — Serapion^tr.
ii. 25. — ^Averrhoes, Colliget. vi. 34. — Mesne, de JEgr. Feet. c. 6.-— Avicenna,
lib iii. f. 10. tr. 3. c. 4. — ^Avenzoar, lib. i. tr. 16. c. 5. — Haly Abbas,
Tkeor. ix. 26., Pract. vi. 10. — Alsaharavius, xii. 6. — Rhases, ad Mamor. ix.
59., ContinenSj lib. ix.
The father of medicine has mentioned this disease casually; but we shall
confine our attention to those writers who have treated of it more at large.
The description given by Aretseus is exceedingly accurate. Blood that
is discharged by the mouth, he remarks, may come Croin the fauces> nose.
V
410 COIIliBNTART OK THE THIRD BOOK.
and palate, in which cases it is seldom attended with danger; or, from the
lungs and arteria trachea, which is exceedingly dangerous, and may prore
fatal either suddenly, or by terminating in consumption; or, from the
stomach, which is less dangerous, as the remedies can be applied direct to
the part affected ; or, from the li^er and spleen, which is a more dangerous
case, as the remedies cannot be so readily applied to them. They all arise,
he says, from rupture, erosion, or rarefaction. By rarefaction (apoiiua-tf) he
means the same as dilataiion {avatrrofiwns). If the blood be black and
thick, it comes from a vein ; and, if ik>rid and thin, from an artery. Of these
cases, that in which it proceeds from rarefectioa is said to be the least
dangerous, as it may readily be cured by astringents. The circumstances
and characters of all the other cases are stated with great accuracy and at
some length. Ue concludes with the remark tliat in hemoptysis the patient
despairs from the first, whereas in consumption be flatters himself with the
hopes of recovery to the last. With regard to the treatment, he directs that
the patient be laid on a firm couch (as all motion increases the complaint),
in a cool place, and that he abstain from speaking and all mental emotions.
In every case, if the patient's strength will permit, he recommends venesec-
tion at the elbow. Ligatures not so tight as to occasion pain are to be applied
to the extremities. Over the place from which the blood flows be diieets to
apply wool or sponges soakcKd in austere wine and rose-oil or in vinegar. In
certain cases he directs to put an astringent plaster upon the chest. With
regard to the noedicines taken by the month, he recommends astringents when
the disease is occasioned by dilatation. These, however, are only to be given
when no fever is present. The diet is the same as that recommended by our
author.
The account given by Celsus is very similar and highly interesting. He
approves of bleeding, the internal and external use of vinegar, and cold water
to drink. Part of his treatment deserves to be given in his own inimitable
language i-^^ Prater hsec necessaria sunt quies, securitas, silentium. Caput
hujus quoque cubantis sublime esse debet^ rect^ue tondetar. Facies aanie
aquSL frigid^ fovenda est. At inimica sunt vinum, balneom, veuos, in cibo
oleum, acria omnia, item calida fomenta, conclave calidum et ioclusum,
mulla vestimenta corpori injecta, etiam firictiones. In hoc casu per hiemem,
locis maritimis; per sstatem, mediterraneis opus est."
Scribonius Largus among other remedies mentions sponging the chest
with vinegar.
The account given by Aetius is full and judicious, but mostly borrowed
from Galen, He approves of the internal use of vinegar, and of applying to
the chest wool soakea in the same.
Oribasius, Actuarius, and Nonnus, recommend internal remedies like those
of our author.
Alexander's observations are exceedingly judicious ; but I can only afloid
room to state his opinion of external applications. He approves of embro-
cations by meaiis of wool soaked in rose^il, or the like, with some vinegar
or aostefe wine not very old ; but recommends to change -the applioatioD
frequently, as by allowing it to remain it will only irritate and provoke the
flow of blood. With such precautions Octavius Horatianus, in like man-
ner, approves of spongine the chest with sour wine and water, or vinegar.
Alexander properly forbids to give any thing warm^ and cautions against
violent exercise, anger, venery, and saltish food.
Galen expounds the pathology and principles of treatment so fiilly, that I
cannot even venture to give an abridgment of his account, but will venture
to recommend it to the serious attention of the medical reader. I must not
omit, however, what he says respecting the use of cold and astringent appli-
cations to the chest : — '' I do not, like most physicians^ approve of applying
COMMBNTART ON TB£ THIAB BOOK. 411
externally astringents, or things which are of a cooling nature without as^
tniigency> in cases of hemorrliage ; for it appears to me that they have
sometimes the contrary effect from what they were intended to produce, as
they occasion a determination inwardly and congestion in the deep-seated
veins. I have, therefore, known cases of persons affected with spitting of
blood who were evidently h'urt by the application .of cold to the chest.
Wherefore, in cases of lieroonrhage, I do not approve of the indiscriminate
use of cold applications/' — Meth, Med, v. 6.— -See also de Const. Artk
Med. c. 16. Galen mentions that blood may run down from the fauces into
the wind- pipe, and thereby occasion groundless apprehensions of haemop-
tysis. Van Swieten states that such a case occurred in his own person. —
Coinntent,^ 1198.
It deserves to be remarked that Dioscorid^, I^linyy Galen, Alexander^
and Paulus, agree in recommending the haematite, or blood-stone, for hsmop*
tysis. It is a native oxide of iron.
To the long and accurate account given by Ctelius Aurelianus it is im-
possible to do justice in a short abstract. Passing over entirely his descrip-
tion of the symptoms, and explanation of the sources from which the blood
is discharged, I shall merely dwell upon a few points of his practice. He
insists vnth proper earnestness on the necessity of complete rest, coolness,
and abstinence from every thing of a stimulant nature; and recommends the
practice already ofVen mentioned of applying to the part affected sponges Gt
compresses soaked in cold water, or in water and vinegar, or in some as-
tringent decoction. He also approves of the application of ointments or
plasters composed of galls, alum, the rind of the pomegranate, and the like.
From among his many internal medicines I would point out the composition
consisting of gum acacia, alum, and the decoction of poppies. When the
discharge does not stop before the third day he recommends venesection.
But, if pain, difficulty of breathing, or a dry cough should come on, he ap-
proves of bleeding at an earlier period of the disease. He then directs to
give emollient epithemes, electuaries containing frankincense and opium,
and the like. When the pain is protracted, he recommends to apply
cupping-instruments or leeches to the part affected. Food of a middle qua-
lily, milk, and the like are to be given. From his strictures upon the pracs
tice of the others it appears that some of the medical sects had condemned
venesection, but it is satisfactory to know that most of the authorities were
agreed about the propriety of it. The Methodist forbids it when there ar^ no
symptoms ef inflammation present. It seems there were disputes also about
the propriety of ligatures to the extremities, but Cailius pronounces in favour
of this practice. He informs us further that some questioned the propriety
of giving vinegar, but he decidedly approves of it. When there is tainy in-
flammation he disapproves entirely of astringents. He also condemns sudo-
rrfics and diuretics. He allows exereise only when the complaint has abated.
Marcellus condemns ligatures to the extremities, but approves of applying
to the chest a sponge soaked in cold water or acrid vine^r.
I have not room for many extracts from the Arabians, who, however, sup-
ply little additional information, although they treat fiilly of the disease. I
would refer to Avicenna's account as being particularly full and excellent.
He approves of the internal use of vinegar, and, when there is a tickling
cough, of anodynes, such as mandragora, henbane, and poppy. Rhases and
Serapion approve of sponging the chest with vinegar. Averrhoes, who is
fond of contradicting preceding authorities, condemns the practice of giving
vinegar in haemoptysis. Mesue recommends to use chalybeate water for
drink. He approves in general of astringents. Haly Abbas gives a very
full and interesting account of the causes* and varieties of the disease, and
lie modifies his treatment accordingly. He recommends bleeding from the
412 COMMBNTARY ON THB THIRD BOOK.
basilic vein, to be repeated if circumstances require, purging with gentle laxa-
tives, such as myrobalans and rhubarb, giving demulcents, such as gum arabic
and starch, to which poppy is sometimes to be added, for allaying irritation. He
directs to avoid the bath, strong exercise, and vociferation. When the disease
arises from a cold cause (he means in cases of passive hemorrhage), he prohibits
venesection, and recommends stimulants, such as frankincense and myrrh.
In certain cases he allows astringents, such as alum, balaustine, galls, sumach,
&c. lie also directs to apply to the breast an astringent cerate containing
roses, plantain, purslain, &c. Alsaharavius recommends bleeding, cold ap-
plications to the chest, opiates, and astringents, according to circumstances.
Uhases states that opium, by thickening or congealing the blood, proves use-
ful in haemoptysis. He approves very much of a milk diet. In general he
recommends venesection. He directs the physician to be at pains to ascer-
tain from wliat part the blood proceeds.
Cold applications to the chest are not now generally resorted to, and yet an
amateur practitioner in the west of Scotland lately acquired great celebrity for
curing hemoptysis by sponging the chest with vinegar. Van Swieten men-
tions cases in which very cold water given internally and applied externally
Xo the chest had effected a cure. — Comment, § 1200. It will be remarked, how-
ever, that Galen condemns the indiscriminate use of this remedy ; and Rbases
also states that he had seen mischief produced by the unseasonable applica-
tion of cold to the chest. In short, like every other mode of practice, it ought,
no doubt, to be applied with proper caution and discrimination.
XXXII. ON BMPTBMA AND PHTHISIS.
See Hippocrates, de Marb'u, lib. ii. c. 4.5., Coaca Pranoi. et alibi, —
Galenus, Mcth, Med. lib. v. — Aretaeus, Morb. Citron, i. 8. — Aetius, viii.
7.5. — Oribasius, Syn, ix.— Alexander, vii. 2, 3, 4. — Actuarius, Meth, Med,
iv. 4., and i. 17. — Nonnus, c. 123, — Cslius Aurelianus, Morb, Tard, ii. 14.,
and V. 8. — Celsus, iii. 22. — Octavios Horatianus, ii. 8.— Marcellus, c. 17.
— Avicenna, lib. iii. fen. 10. tr. 5. — Mesne, de Mgrit, Feet, ii, 12. — Sera-
pion, tr. ii. 27. — ^Alsaharavius, Pract, xiii. 3. — Haly Abbas^ Pract. vi. 12.,
Fheor, ix. 20. — ^Avenzoar, lib. u tr. 16. c. 4. — Rhases, ad Mamor, ix. 60.,
CorUinens, lib. x.
Hippocrates states, as tests of the nature of the sputa, that, if they possess
a fetid smell, or sink to the bottom of salt water, tney indicate great danger.
When a collection of pus is suspected, he directs to shake the patient, when
a peculiar sound will be heard if there be fluid in the chest. In that case,
he directs to make an incision into tlie chest, in other words he recommends
Paracentesis Thoracis, an operation revived of late years. In his Prognostics
he pronounces a falling out of the hairs and a diarrhcea to be fiUal symptoms
in Phthisis.
Aretsus gives a good description of the phenomena attending Empyema
Thoracis. He says that when the abscess points outwardly it separates the
ribs from one another to make room for itself. It is occasioned, he says, by
inflammation with a collection of blood. But the most graphic delineation
of the phenomena of disease to be found in the whole records of medicine is
that which he draws of a patient in the last stage of consumption. I will not
mar it by attempting a copy which would hW so short of the original. He
does not approve of the common tests, as recommended by Hippocrates ; and,
instead of forming an opinion of the case by throwing the sputa upon 6re
or water, he prudently airects to judge of the case from the general symp-
toms. Unfortunately only a fragment of the chapter on the treatipent has
COMMENTARY ON THB THIRD BOOK. 41S
€ome down to us. It appears from it that he approved of a milk diet and a
sea-voyage.
Celsus recommends in particular a sea-voyage, change of air, gestation in
a couch, and a milk diet. He cautions against the bath and exposure to the
sun or cold. When these means do not effect a cure, he directs to bum the
chest in different places with the Actual Cautery, so as to form issues (see a
strong recommendation of this practice in Caillot, Elemens de Fhyswlogie,
p. 6.).
Galen has detailed the principles upon which Phthisis ought to be treated
in the Fifth Book of the Meth, Med, He commends strongly a diet of
milk, especially that of goats, which is, he says, of an interm^iate consis-
Vesmce between the milk of cows and of asses. The ancients, he says, made
ooosucnptive patients suck a woman. Whatever kind be used, he recom-
mends it to be drank as soon as it is milked from the animal ; and he fur-
ther directs sometimes to add honey or a little salt to it.
Alexander gives very judicious directions for the choice of milk, and treats
of empyema otherwise very fully.
Aeti us states, upon the authority of Archigenes, that in certain cases em-
pyema is formed without fever. This is now well ascertained to be the case.
He approves of the Cautery, like Celsus. His account of Phthisis is taken
Irom Galen.
Cslius gives many important observations on the proper treatment of con-
sumption, and strictures on the practice of the other sects. He remarks cor-
rectly that in old coughs attended with fever, although the expectoration b6
at first transparent and not purulent, the complaint often terminates in
Phthisis. His treatment is judiciously suited to the circumstances of the
case. He condemns the early use of the bath, hellebore, and the formation
of issues on the part affected. Of the varieties of empyema he has treated
elsewhere at great length. He appears to consider the operation of Paracen-
tesis as dangerous.
Many of the remedies recommended by Marcellus contain a combination
of stimulant with narcotic substances, that is to say, of myrrh, storax, and
the like, with opium and hyoscyamus.
Vegetius, the veterinary surgeon, remarks that tubercles like boiU foi-m in
the lungs of cattle. — Mulom. ii. 45.
Avicenna*s treatment is, in general, like that of Galen and his followers. He
speaks of inhaling the vapours of arsenic, pine-fruit, &c. He and his country-
man, Avenzoar, approve of Paracentesis and the Cautery. Mesne recommends
the tepid bath in the decline of Phthisis. Serapion approves of opening the ab-
scess m cases of Empyema by means of a red-hot iron. In the treatment of
£mpyema, Haly Abbas appears to have put great confidence in absorbent
earths, such as burnt crabs, gum Arabic, Cyprian earth, &c. He gives the milk
of asses in the morning, and at night the syrup of poppies. He also praises
goats' milk. He approves of a milk diet and demulcents likewise in Phthisis.
He makes frequent mention of poppies, doubtless with the view of alleviating
the cough. In certain cases he directs to use the tepid bath ; and, under pro-
per regulations, I am convinced that it might often be of service. The late
Dr. Currie of Liverpool used the tepid aflBiision for mitigating the exacerba-
tions of the Hectic Fever. Haly approves of the tests of purulent expecto-
ration, which we have stated above that Aretaeus condemned. Alsaharavius
says that the bath may prove useful in Phthisis, but timt it ouglit not to be
tried except under the direction of a skilful physician. He seems to direct
first to use the tepid bath in a warm place, and afterwards to go for a short
time into a cold bath. He does not explain the principles of his practice.
He approves, in general, of a milk diet, but directs to change it if a aiarrhcea
come on. The milk of asses or of goats is what he prefers. He approves of
414 COIfMBNTAlIT ON THE THIRD BOOK.
the Hippocratic tests of pus. Rhases describes several species of consump-
tion. One of them he represents as being seated in the trach^. His ac-
count of the various modes of tfeatment is most ample. He strongly com-
mends the milk of asses.
Gralen, Rhases, and most of the ancient authorities held that consumption
is contagious. This opinion very geoendly prevails in Italy, Germany, and
America, at the present day. Fracastorius believed in the contagious nature
of Phthisis. — iSe Morb, Contag, Schenkius, Kiverius, Andre du Laurens,
and Hoffman were of the same opinion. Morton affirms that he had known
the disease to prove infectious. — J^htkisiolcg.
The historian Sallust uses the word l^abes as synonymous with Conta-
gium in the following sentence : — *' Tanta vis morbi, uti tabes, plerosque
civium animos invaserat.** — Catalin, c. 36. Livy does the same in several
places.
XXXIIL — ON PLBVRI8T.
See Hippocrates, de Morbii, lib. ii., de Rat, Vic4. in AcuU — Galenus, de
Med, sec, loc. lib. vii., eialibL — Celsus, iv. 6. — Areteus, Morb, Acut, i. 10.,
Curat, Morb, AaU, i. 10. — ^Aetius, viii. 76. — Psellus, Op. Medieum, —
Alexander, vi. 1. — Oribasius, Syn, ix. 7, 8. — ^Actuarius, Meth. Med, iv. 4. —
Nonnus, c. 129. — Ctelius Aurelianus, Morb, Acut, ii. 13.-— Octavius Hora-
lianus, ii. 4.r— Marcellus, de Medicam, c. 24< — Serapion, tr. ii. 21. — Mesue,
de JEgrit, Pect, c. 7.— -Avicenna, lib. iii. fen. 10. tr. 4. — ^Alsaharavius, Pract,
xii. 8w»Avenzoar, lib. i. tr. 16. c. 4.— Haly Abbas, Theor, ix. 21., Praet.
vi. 13. — Rhases, Divit. 54., ContinenSy lib. x.
Hippocrates gives brief descriptions of Pleurisy, and recommends neariy
the same treatment that is now practised, namely, bleeding ad deliquium
animi, purging, diluent drinks, and fomentations to the side by means of
sponges squemd out of hot water, or of bags filled with salts and caitlet, or
the like.
Aretseus, with his usual accuracy, gives a most coniplele description of
all the symptoms of Pleurisy, but, as it is not much different from our au-
thor's, I shall not enter upon a detail of it. He remarks, by the way, that
Pleurisy is sometimes a sporadic disease, and sometimes epidemical. His
directions about the application of the common remedies are dictated by his
usual excellent judgment On the necessity of early and repealed venesec-
tion he insists strongly, but recommends not to carry it the leegth of pro-
ducing deliquium animi, as the fluids will thereby be determined invrardly.
Archigenes (ap. iBtium) and other ancient authorities joined him in this rule
of practice, although in opposition to Hippocrates. He approves of cap-
ping the side, but not until after the 7th day, and directs to apply to the
scarifications salts or nitre. His internal remedies consist of oenralcents,
diluents, and narcotics, varied acooiding to circumstances. He forbids the
use of cold drink and cold air. Celsus also cautions against cold, and di-
rects to apply sinapisms to the chest. His general treatment is noUiing dif-
jferent from that of Hippocrates.
Galen treats of Pleurisy cursorily in many parts of his works, but, as he
follows entirely the views of Hippocrates, we need not enter into a detail of
his practice.
Psellus cautions not to confound Pleurisy with abscess of the side. In
the latter case, he remarks, there is no cough, and pain is felt upon pressure.
He appears to copy from Pauius.
Aetrus gives an interesting account of a species of Pleurisy arising from
indigestion or crudities of the stomach. In ttiis case he forbids venesection,
and recommends clysters and caleiacient applications.
COMMVNTAAT ON THB THIRD BOOK. 415
Alexander gives very minute directions how to distinguish Pleurisy from
Hepatitis. He remarks that, in the latter disease, the patient is yellowish.
When the pain is not violent, he recommends to trust to cupping, whidi he
says was a popular lemedy in Armenia* He disapproves in general of
Opiates. When the discharges from the howels are oilious, he directs to
Eurge with scammony, black hellebore, and the like. I may remark here,
y the way, that the administration of oxymel and hellebore in certain cases
of Pleurin' was much commended by Gesner ; and I think the practice de-
serving of imitation.
There is nothing particularly original in the accounts given of it by Oriba-
sius, Actuarius, Nonnus, Octavius, and Marcellus. We shall, therefore, pro-
ceed to explain the views of the Methodists. The remedies recommended
by Caelius Aurelianus are, upon the whole, nearly the same as those directed
by the other sects, but he attaches much importance to his own method of
applying them. In illustration of his principles, we shall mention a few of
his strictures upon the practice of the others. He condemns Hippocrates
for carrying venesection the length of producing deliquium animi, which he
pronounces to be a very pernicious practice. Indiscriminate purging, he
thinks, increases irritation. He disapproves of abstinence for seven days, a^
enjoined by the father of medicine. Diocles he blames for enjoining the
same rules with regard to bleeding and purging, and for allowing cold food
in summer. Praxagoras he strongly and properly condemns for giving pep^
per or southern-wood in mulse ; and also for recommending the warm bato^
and fomentations to the side, which he justly remarks will only occasion
cold to the patient; and for prohibiting venesection, when the disease is oc-
casioned by cold, and the patient is old and weak. He finds jfault with
Asclepiades for saying that venesection is not proper in certain countries, as
at Rome and Athens, whereas Cslius properly maintains that venesection is
everywhere proper. It is worthy of remark, by the way, that prejudices
against bleeding prevailed in Rome when Galen wrote, and to a certain ex-
tent do so still. Celius also justly condemns his too free allowance of mulse^
or wine and honey. He blames Themison for using acrid applications to
the chest Of his strictures on the treatment of Heraclides, the most just are
his condemnation of the practice of giving mulse with rue, and garlic with
vinegar, to remove the nausea ; and of bis direction to bleed only on the se-
cond day after two or three clysters had been given.
Of the practice of the Arabians little need be said, as their views of treat-
ment are entirely conformable to those of the Greeks. Avicenna*s directions
are most minute, and would furnish an excellent guide to practice. He for-
bids cold things, and approves of cupping and sinapisms only when the dis-
ease does not yield to the ordinary treatment. When insomnolency continues
long, he permits to give the syrup of poppies. Convalescents are directed to
avoid saltish and sharp things, repletion, the sun, wind, smoke, loud talking,
and the like. Serapion, on the fourth day, adds liquorice to the decoction of
barley. Mesue and Avicenna agree in opinion, that fomentations to the side
do no good unless in slight cases, and when applied early. Mesue forbids
cupping until the seventh day; and, when the stomach and bowels are loaded,
be opens the belly before bleeding. Haly Abbas directs to bleed from the
arm opposite the side affected, at first ; but, if the disease is protracted, from
the arm of the same side. He recommends gentle laxatives, and, after bleed-
ing and purging, warm applications to the side, such as a bladder half filled
with hot water. He also speaks of cupping, and of stimulant plasters, sina-
pisms, and such like. He says, when the body is cleansed, and the disease ma-
tured, the patient is to be put into a tepid bath. This practice m<iy deserve
consideration.
It is worthy of remark that the Arabians in general direct to bleed from
416 COMMENT ART OK THS THISD BOOK.
the arm of the opposite sidie. The Greek and Latin authorities are divrded
in opinion upon this rule of practice. Hippocrates, Galen, and Celsus, recom-
mend to bleed from the arm of the affected side ; but Aretaeus, Aetius, and
Cselius Aurelianus, from the opposite. Galen, in one place, mentions that
he had abstracted blood in a case of Pleurisy by opening one of the arteries
of the hand.
XXXrV. ON AFFBCTIONS OP THB HBART.
See Oalenus, de Loc. Affect. — Aetius, viii. 58. — Oribasius. Synop, ix. 6.
Actuarius, Meth, Med, iv. 3. — Nonnus, c. 134. — Avicenna, lib. iii. fen. 11.
ir. 1. and 2.— Serapion, tr. ii. 27. — Avenzoar, i. 12. — Mesue, de .Mgrit, Ftct,
— Haly Abbas, Theor, ix. 22., and Pract. vi. 16. — Alsaharavius, Fract. xiii.
— Rhases, DivU, i. 58., and Conttnem, lib. xvi.
Most of the knowledge which the ancients possessed of these obscure com-
plaints may be found in Galen, u. $. In the body of a monkey he bad
remarked Hydrops Pericardii, and in that of a oock he had detected a
'Scirrhous Tumour, from which he inferred that these diseases occur also
in the human subject. One would almost suspect, however, that the an-
•cients were more familiar with impectumei cumverum than they chose to
avow. As a proof of this, I may mention what is related by Hesycbius of
Hermogenes the rhetorician :-*'' Uermogenes the rhetorician having died
was dissected, and his heart was found covered with hair, and greatly exceed-
ing its natural size." (See also Suidas.) Sespeoting pecsons having hair on
their hearts, I quote the following note from Falbricii Bibiiot/teca Uraea^ t.
iv. p. 429^— ''rlura exempla itominum quorum cor pilosum est repertam
collegit elegantissimus, Muretui xii. 10. V(w. Lect^ Pootanus, Bellar. Altie.
p. 301. et Alexander Tassonus in libro Italic^ edito cui titulus Fenueri
Uivertiy lib. vi. c. 30. De Aristomene Messenio idem tradit preter alios
Dio. Chrysost. xxxv. p. 430. de Leonida Plutarchus in parallelis minoribus,
p. 306." On the subject we are treating of the learned Stephen Bernard has
the following remark: — "Apparet, ni fallor, ex hoc looo Pauli (iii. 68.)
veteres morborum sedes in cadaveribus rimari non neglexisse quod etiam
patet ex illis quce de hepatis inflammatione habet, c. 181 . qui enim scire po-
terant aliquando partem «jtis «avam, nonminquam vero gibbam inflaoana-
tione tentari nisi ex cadaverum iospectione? — Ap, Nonui Epit, c. 208.
ISee also Pirn. If. N. xi. 70. and the note of Ha^duin.
Sraee all the writers subsequent to Galen merely copy from him, I need
not say more of their opinions.
The Arabians, especially Avicenna, treat of these complaints at gieat length,
but without supplying much additional information. Avenzoar speaks ob>
scurely of certam tumours resembHag pellicles or -cartilages on the Pericar-
dium. He mentions also Hydrops Pericardii and abscess of the same.
Pain of the heart, says Haly Abbas, may arise from an intemperament,
organic disease, or a solution of -continuity. The two last causes -sooa
occasion death. He mentions that palpitation may be occasioned by Dropsjr
of the Pericardium. He recommeiUs bleeding in oases of palpitation, upon
the authority -of Galen, and also things ofa<GoId nature, such as seeds of cu*
cambers, -citrons, gourds, roses, and camphor. Alsaharavius g^es a similar
account of these affections. Uhases also approves of venesection and cold
applications. Fie mentions that palpitation is sometimes felt in the region
of the stomach, for which he properly recommends bitters, such as worm-
wood.
Of the Cardiac disease, which is treated of very circumstantially by Are-
tsus, Celius Aurelianus, and others, I sfhall not make further mention here.
COMMBNTART ON THE THIRD BOOK. 417
as it is not agreed that it was necessarily an afTection of the heart. Caelius
and Celsus may be particularly consulted for further information respect-
ing it.
XXXV.— ON AFVBCTIONS OF THE BREASTS.
See Oribasius, Synop* ix. 9. — AetiuSyXvi. 35. — Nonnus, o. 151. — Scri-
bonkis Largus, c. 1*02. — ^Avicenna, lib. iii. fen. 12. — Haly Abbas, Theor.
ix. 40., Pract, Fiii. 29. — Alsaharavius, Fract. tr. xiv., and Rhases, Conti-
nentf lib. xt.
A considerable part of this chapter is copied from Oribasius. Aetius,
however, has treated of these complaints more fully than any other author.
He gives from Philuraenus various prescriptions for inflamed breasts, the
most important ingredients in which seem to be ceruse and litharge, with
wax or honey. One of them also contains the recent leaves of henbane^ evi-
dently for the purpose of allaying pain. For indurated mamme, he directs
to apply linseed, or the seed of fenugreek with hydromel. In short, his ap-
plications and our author's are very similar. When an abscess forms, he
recommends to open it and evacuate the pus. Nonnus, as usual, copies from
•ur author.
Avicenna treats fully of these complaints, but his remedies are mostly
borrowed from the Greeks. The most simple of his applications for
s^postemes of the breasts is a sponge squeezed out of tepid vinegar and
water. Haly Abbas recommends the same, or a plaster of the oil of roses,
bread, and the yolk of an egg. When suppuration is expected, he directs to
apply a ^atsmlasm of figs. Alsaharavius treats minutely of this subject.
Wnen pain of the breast arises from coagulated milk, he recommends to ap-
ply a piece of cloth soaked in warm water or vinegar. When milk cannot
oe extracted from the breasts, he directs to suck them by means of a suitable
instrument shaped like a nipple. To dispel coagulated milk, Rhases recom-
mends a mixture of hot vinegar and rose-oil. He also recommends a com-
j)Osition of mint and common salt.
XXXVI. OK FETID 8MKLL, AND SWBATTNO OF THE ARM-PITS.
See in particular Oribasius, Sj/nop, viii. 36. — Nonnus, c. 155. — Geopon,
xii. 26. — Alsaharavius, Pract, tr. xv. — Rhases, ad Mansor, v. 51 ., and Vou-
tinerUy xxxvi.
Ail the authorities concur in recommending to cure this complaint by a
combination of astringents with aromatics. They, therefore, direct to mix
alum with storax, myrrh, and the like. Rhases recommends tutty with rose-
water and camphor, and also various astringent and odoriferous liniments.
The plan of treatment directed by Alsaharavius is deserving of attention. He
recommends to purge with the hiera picra. This is an important point of
practice. I remember that the late Mr. Wilson, of Great Windmill Street
Theatre of Anatomy, used to mention in his lectures, that a servant of Mr.
Croickshank, the <:elebrated anatomist, was cured of this nasty complaint by
a course of active purgatives. Alsaharavius further recommends a bath in
which mint, marjoram, centaury, spikenard, and the like have been boiled.
The part is afterwards to be rubbed with an ointment consisting of litharge
or tutty, mixed with alum, myrrh, &c. in fragrant wine.
The ancients believed that living freely upon Bgs rendered the perspiration
fetid. Eustathius, the Commentator on Homer, makes mention of two So-
phists, called Anchimolus and Mochus, who lived solely upon figs for food,
It e
418 COMMBNTART ON THB THIRD BOOK.
and water for drink ; and he adds that their perspiration was so fetid, that
when in the bath every body shunned them. — Ap. Iliad, xiii. 6.
XXXVII. ON STOMACH COMPLAINTS.
See Aretseus, Morb, Chron. ii. 8. — Caelius Aurelianus, Pass, Tard. iii. 2.
— Celsus, iv. 5. — ^Galenus, de Med. sec. loc, Mb, vi. — Oribasius, Synop, ix.
10. — Aetius, lib. ix. 1. — ^Alexander, vii. 5. — Actuarius, Meth, Med. iv. 5. —
Octavius Horatianus, ii. 16. — Marcellas, de Med, c. 20.— Avicenna, lib; iii.-
fen. 13. tr. 1, 2, 3. — Serapion, tr. i. c. 1. — Avenzoar, lib. i. tr. 15.— Aver-
rhoes, Colliget. v. 54. — Haly Abbas, Pract. vii. 2., Theor. ix. 24. — Alsahara-
vius, Pract, tr. 16. — Rhases, Divis, c. 59., Continens, lib. xi.
To all these authors, almost every one of whom has treated of these com-
plaints more fully than Paulus, or upon a diflferent plan, it is quite impossi-
ble for me to do justice within the narrow limits to which I confine myself
in these annotations. I shall, therefore, direct my attention principally to
Celsus, and merely add a few remarks from the others. The stomach, he
says, is affected by great heat, inflation, inflammation, and ulceration ; by
phlegm or bile ; and by resolution, which is a common and fatal coxnplaint.
Heat is to be cured by cold external applications, such as vinegar and rosesj
along with cold drink. Inflation we shall see treated of in the next chapter.
Inflammation which is attended with pain is to be treated by rest, "abstinence,
sulphurated wool, and wormwood, when fasting. If attended • with ardor,
he prescribes cold and repellent applications, occasionally exercise, and a
ftiller diet. Ulceration is to be cured by exercise, friction of the extremities,
smooth and glutinous food, and avoiding every thing that is acid and acrid.
Redundance of phlegm is to be treated by emetics, exercise, friction, hot
drink, and hot food. When bile prevails, he recommends laxatives, potions
of wormwood, gestation, or a sea-voyage ; emetics, if they can be conveniently
borne, and suitable food, so as to avoid indigestion. Resolution, he says, is
a severe affection of the stomach when it cannot retain the food, and the body
wastes. The bath, he says, is useless, but exercise of the upper parts of the
body peculiarly proper. He recommends pouring cold water on the stomach,
swimming in the same, and living on cold food, rather such as is difficult to
digest than what will readily spoil on the stomach. Hence, he says, some
digest beef. Undiluted austere wine, either cold or very hot, is proper. If
there is vomiting with pain, he directs to apply over the stomach, wool or.
sponge soaked in vinegar, or cold cataplasms ; or, if the pain be more severe,
a cupping-instrument; then bread which has been steeped in cold diluted
. wine is to be given. If this is not retained, some smooth article of food not
disagreeable to the stomach is to be administered ; and, if this is hot retained,
a cupful of wine is to be taken every hour until the stomach becomes settled.
He also praises an acid mixture containing pomegranate, endive, &c.
AretKus gives a lively description of the feelings of a dyspeptic. The stu-
dent who follows his divine pursuits with indiscreet ardour, and neglects to
take proper food and exercise, is said to be particularly liable to this affec-
tion. The cure, he says, is to be accomplished by gestation, vociferation, a
suitable diet, and indulgence of the patient's caprices as far as possible.
Wormwood, ginger, aloes, and mastich are also proper.
Alexander properly remarks that disorder of the stomach affects sympa-
thetically the heart and brain. He treats fully of inflammation of the sto-
mach, for which he directs to give relaxants and tonics, such as wormwood
and mastich. It is singular that he and most of the ancient authorities have
omitted to mention venesection for this complaint. I therefore entertain
some doubts whether they meant by it the gastritis of modern Nosologisls,
COMIfBNTART ON THE THIRD BOOK.' 419
which, by the bye, is of so rare occurrenoe, that some late writers of high
name are of opinion that it never occurs spontaneously.— (See Christison on
Poisons.) Some of the ancient authors, however, do recommend venesection
in this complaint, as, for example, Serapion, Rhases, Avicenna, and Haly
Abbas. Horatianus recommends the same for sudden pains of the stomach.
Cttlius Aurelianus, while treating in general terms of stomach complaints,
recommends bleeding, ** si in vehementiam passio venerit.'^ He also makes
tnention of cupping and leeching. His accoutit of these affections is highly
interesting, bat so circumstantial that I dare not venture eveu upon an
abridgment of it. Haly Abbas speaks of inflammation ending in suppura-
tion. To Alsaharavius 1 particularly invite attention. Rhases gives a copious
statement of the opinions of all preceding authorities on this subject.
XXXVIII. ON INFLATION OF THB STOMACH.
S€E all die authors referred to in the preceding chapter.
Our author's treatment, which consists of dry copping, dry fomentations,
and the internal use of calefacients and wine, is what Celsus also recommends.
He likewise speaks favourably of exercising the upper parts of the body, cff
friction, and of using purgatives Occasionally, and sometimes, though rarely,
the bath. Serapion, Rhases, and Avicenna, recommend similar treatment,
namely, purgatives and aromatics, such as aloes, anise, calaraint, cumin, and
the like. Haly Abbas directs to avoid all flatulent food such as pulse, milk,
and grapes; recommends the bath after much exercise and before dinner, and
to get uie stomach rubbed, and a cataplasm of salt and cumin applied to it.
He also directs to administer many calefacient and carminative articles such
as anise, rue, castor with old wine, also the peppers, theriac, mithridate, hiera
picra,&c. Alsaharavius recommends aromatics and carminatives, and after-
wards to rub the pit of the stomach with calefacient oils. Averrhoes directs
to give all solid food, as flesh, puddings, &c. quite cold ; but spoon-meats
may be eaten as warm as the blood or somewhat warmer. This method,
he adds, will clear the head and stomach of wind, beget finer blood, brisker
spirits, and cause a lively circulation of all the humours.
Rhases and Avicenna describe Ulceration of the Stomach very accurately,
smd also thickening of its coats.
Avicenna mentions Rupture of the Stomach, but does not say whether he
alludes to spontaneous rupture or rupture from accident.
The learned Commentator on Mesue, Franciscus de Pedemont,who flourish-
ed about the beginning of the fourteenth century, gives a very full and accurate
account of Ulceration of the Stomach. — De JEgrit. Stomach, c. 13. M.
Gerard and Dr. Abercrombie have lately published several cases of it.
XXXIX. — ON CHOLBRA.
Consult Hippocrates, Epideni, v. 4. et alibi. — Galenus, Comment, de Fac
Partly de Rut, Vict.^ de Med. sec loc, lib. viii. — Aretaeus, Morb, Acut* ii. 5.,
de Curat. M. A. ii. 4. — Celsus, iv. 11. — Alexander, vii. 16. — Aetius,ix. 12.
— Oiibasius, Morb, Curat, iii. 11. — Actuarius, Meth, Med, iv. 5. — Nonnus,
c. 164. — Cassius Medicus, Problem, — Scribonius Largus. — Caelius Aure-
lianus, Morb, Acnt, iii. 19.—- Octavius Horatianus, ii. 16. — Marcellus, c. 30. —
Avicenna, lib. iii. fen. 16. tr. 1. — Serapion, iii. 14. — ^Avenzoar, ii. 1. —
Alsaharavius, xvi. 20. — Haly Abbas, Tract, vii. 14., Theor, ix. 25. — Rhases,
Divii. 60., ContinenSj lib. xi., ad 3fansor. lib. ix.
Hippocrates in his epidemics has given several well-detailed cases of
E e 2
420 COMMBNTARY ON THB THIRD BOOK.
Cholera. In one, the patient drank hellebore in the juice of lentils and vo-
mited ; he became cold, and was put into the hot hip-bath, where he re*
gained his heat and recovered. In another place, he says that the disease is»
for the most part, occasioned by unwholesome food, such as pork improperly
boiled, potrherbs, summer fruits, &c.
Aretseus defines Cholera to be a retrograde movement of the matters in the
body upon the stomach and intestines, consisting of a discharge upwards and
downwards of bile, which, if the disease proves fatal, becomes black ; and, at
the same time, the extremities are cold, with profuse sweats, pulse sipall and
dense, constant straining to vomit and tenesmus. He also makes mention,
among the symptoms, of spasms and contractions of the muscles in the legs
and arms, borborygmi, tormina, and syncope. The complaint, he says, is
occasioned by continued indigestion; and proves fatal by superinducing con-
vulsions, suffocation, and retching. With regard to the treatment, he cau-
tions not to stop the discharge at first, but to encourage it, by giving fre-
quently some tepid water ; and, when attended with tormina and coldness of
the feet, to apply to the belly hot oil of rue, and rub the legs to restore heat.
When the feces are all evacuated, he recommends some cold water to com-
pose the stomach ; and, when the pulse sinks and becomes frequent, while, at
the same time, there are profuse sweats and deliquium, he approves of adding
a small quantity of wine to the water. It is to be of a fragrant and astrin-
gent kind, so as to strengthen the powers of the system. When all the symp-
toms get worse, when spasms of the legs occur, and the pulse becomes insen^
sible, he advises to give more wine and water. Should the vomiting continue,
we must return to very hot drink and hot food, for, he remarks, the transition
often proves beneficial. When all these fail, a cupping-instrumeut is to be
put on between the shoulders or below the navel. He afterwards speaks of
such applications as those recommended by our author, namely, calefacients
applied to the belly, chest, and legs. He concludes with saying, that, if the
symptoms, instead of improving, should get worse after this treatment, it will
be proper for the physician to accelerate his retreat.
When Cholera is not attended with Fever, Galen approves of giving a
piece of bread soaked in diluted wine, of cold drink, and of applying cupping-
mstruments to the belly. When the patient is strong, he even recommends
the cold bath. He directs afterwards to give astringent food, and also speaks
of clysters, old wine, and asses' milk. He mentions with seeming approba-
tion that Asclepiades gave tepid water at the commencement.
Celsus depends most upon tepid water, dry cupping and sinapisms to the
belly. In extreme cases, he directs to give a light fragrant wine diluted with
water.
Alexander's account is very minute, but little different from that of
Aretaeus. In certain cases, he permits poppies to remove insomnolency
and wine to support the strength. Like Hippocrates, he describes correctly
the Dry Cholera.
Aetius, Oribasius, Actuarius, and Nonnus, treat of the disease in nearly
the same terms as our author.
For Cholera, Marcellus recommends various astringent remedies, both ex-
ternally and internally. Myrtle wine, be says, will stop the vomiting. He
also commends opium.
Octavius Horatianus calls Cholera " omnibus acutis segritudinibus velo-
cior.*' Like the others, he recommends draughts of tepid water at the com-
mencement, and wine and aromatics in extreme cases.
Caelius Aurelianus, with his accustomed accumcy, gives a complete history
of the symptoms of this disease. The bile which is vomited, he says, is at
first yellow, afterwards green, and at last black. His treatment is very sisii-
lar to that of Aretseus,' namely, tepid water at the commencement to facili-
COMMENTARY ON THE THIRD BOOK. 421
tate\omitiDg, sponges out of cold water applied over the stomach, or else
cupping-instruments with much heat; aromatics, bread soaked in wine, and
the like. He condemns Hippocrates for sanctioning the giving of hellebore.
He blames Diodes for recommending southernwood, which, he' remarks, is a
very harsh medicine ; and also for allowing milk, which, he says, is apt to
grow acid. He finds fault with Heraclides Tarentinus for trusting to opium
and henbane.
Cassius Medicus accounts for the coldness of the extremities and contrac*
tions thereof upon the supposition that they are occasioned by the vital spirits
having left them and been determined to the stomach.
There is nothing very, interesting in the works of the Arabians. Haly re-
marks that Cholera consists of a discharge of bile. He inculcates as a set-
tled principle of treatment, that, when the strength continues good, and the
discharge not immoderate, the vomiting is to be encouraged by giving tepid
water with oil of sweet almonds to drink. When there is great prostration
of strength and tendency to deliquium, he directs to sprinkle water on the pa-
tient's face, to apply ligatures to his limbs, and to rub his feet and legs with
a calefacient oil. When the discharge cannot be got otherwise stopt, he
advises to apply a cupping-instrument over the stomach. Alsaharavius, like
the others, directs to promote the vomiting at first by giving tepid water.
Among his other remedies, he recommends an infusion of aloes and worm-
wood. Rhases recommends draughts of tepid water, the application of snow
over the stomach, ligatures to the extremities, wine, and astringents. He,
Avicenna, and most of the authorities direct to encourage sleep. Avicenna's
plan of treatment is exactly the same as that of Rhases.
With respect to diarrhoea, Celsus recommends to give an emetic; to anoint
next day with oil ; to give moderate food and undiluted wine ; and to apply
over the belly a cerate with rue. C«lius Aurelianus enjoins at first rest and
abstinence, then astringent applications to the belly, next day astringent
food, and then wine and the bath. Haly Abbas remarks that a diarrhcea i$
not to be rashly stopt unless it become excessive, in which case astringents
are to be given, such as galls, roses, pomegranate fruit, &c. Serapion and
Rhases mention an emetic as a remedy for diarrhoea ; and, as Dr. Milward re-
marks^ " the moderns make use of a course of vomits as the last refuge in an
obstinate diarrhoea.**
For the cure of diarrhoea, the veterinary surgeons recommend at first bleed-
ing and hot water, and then astringents, such as sumach and pomegranate
rind. — Geopon. xvi. 8.
I have given a fuller history of the ancient opinions on Cholera in the
.London Medical and Physical Journal for November, 1831.
XL. ON LIENTBRY AND COELIAC AFFECTION.
Hippocrates, Aphor. de Affect. — Galenus, in Hipp. Aphor. Comment, vi.
.1., de Med. sec. loc. lib. vii. — ^Aretaeus, Morb. Chron. ii. 10. — Celsus, iv.
16. — ^Nonnus, c. 166. — Theophilus, de Alvi Retrim.c. 2. — Actuarius, Meth,
Med. i. 42. — Aetius, ix. 37. — Oribasius, Morb. Curat, iv. 88. — Psellus,
Opus Medicum. — Scribonius Largus,c. xi.r— Marcellus, de Medicam. c. 27.— •
Avicenna, lib. iii. fen. 16. tr. 1. — Serapion, iii. 18. — Haly Abbas, Theor, ix.
25., Tract, vii. 16. — Alsaharavius, Pract, xvii. 1. — Rhases, ad Mansor. ix.
72., Continens^ lib. xiii.
In Lientery, says Hippocrates, the food passes through the bowels in a
liquid state and without change. Galen remarks that the affection may be
defined to be a loss of digestion, the food having undergone no change in
422 COMMXMTAKT ON TAX THIRD BOOK.
consistence, smell, or quality, vrhile in the bowels. The intestines, he says^
are either in a state of ulceratioo and great tenderness, or they have lost their
retentive &culty»
Psellus defines Lientery to be a loss of the retentive faculty of the bowels,
so that the food passes undigested in a liquid state.
Aretseus calls it a disease arising from broad ulcers of the intestines when
the food passes through the bowels not at all altered. With respect to the
treatment, he merely says that an emetic after food will remove it.
Celstts recommends astringent food, stimulant and rubefacient applications
externally ; and afterwards exercise, friction, insolation, and vomitmg, which,
he says, Hippocrates directed to produce with white hellebore when other
things ^il.
Dioscorides states that, when the inner membrane of a cock's stomach has
been dried and reduced to powder, it may be given triturated in wine with
great advantage in stomach complaints. Our author, it will be remarked',
makes mention of this medicinal articlef.
Archigenes and Aetius describe Ceeliac Affectioti as an atony of the in-
testines, so that the food is not retained until it is digested. They treat of
it at great length, their principal remedial measures being purging, Tomiting,
and astringent applications. According to Psellus it arises from superficial
ulceration of the intestines.
Serapion for Lientery directs to give astringent decoctions, and to apply to
the belly an astringent epitheme containing galls, roses, pomegranate
flowers, &c. the food to consist principally of millet and the like. He
also recommends a mixture of goat's milk and water boiled- until the water
evaporate. Whed the stomach is loaded he recommends an emetic. In
Ceeliac Affection he directs to strengthen the intestines by astringents inter-
nally and externally. Haly Abbas defines Lientery to be a quick discharge
of the food in an unchanged state. It arises, he adds, from immoderate de-
bility of the retentive faculty of the intestines, or from excess of the expulsive.
It is said to be generally caused by ulcers which, being irritated by the food,
stimulate the intestines to expel it. He recommends a variety of remedies,
most of which are either astringents or acids, such as balaustine, rind of
acorns, mastich, sumach, galls, roses, &c.
XLI. — ON TBNB8MUS.
See the authors referred to in the preceding chapter.
Celsus recommends the tepid bath, emollient and astringent applications
to the rectum, such as butter and roses, or alum wrapped in wool and ap-
plied, the remedies for tormina, and an austere wine every alternate day.
Aetius may be referred to as an author who has treated of this affection in
a very accurate manner, although nearly to the same effect as our author.
Among other things he mentions the application to the anus of a sponge
soaked in a solution of galls in vinegar.
Nonnus defines Tenesmus to be an inflammation of the rectum, and says
that it is to be benefited by injections of the oil of rue, or of wine and honey
with brine; by hip-baths of astringent decoctions, such as myrdes, bays, &c.
or by fomentations with a sponge.
Avioenna describes two varieties of Tenesmus, the False, which is occa-
sioned by the lodgement of hardened faeces in the intestines, and is to be
cured by emollient clysters, &c.; and the True, which> if occasioned by cold,
is to be relieved by fomenting the parts with a sponge or the like soaked
in hot water; if by hard pressure, a sponge is to oe sqneecod out of hot oil
aud applied ; if by an aposteme, it is to be treated upon general principles
CX)MMBNT4RY ON THB THIRD BOOK. 423
by bleeding and embrocations; if by a flux, remedies suited to that com-
{Uaint are to be given ; and, if by ulcers, the common applications to them
are to be used. Haly Abbas treats fully of Tenesmus, like Avicenna. In se-
veral of his prescriptions poppies and opium occur. When produced by
retention of scybalae, be recommends powerful evacuants, such as colocynth,
prunes, turbit, scammonv, &c. One of Serapion's prescriptions contains
burnt lead, sumach, myrrh, &c.
XLII. ON DY8BNTERT.
Consult Hippocrates, Aphoris.^ de Affect. Epidem. — Galenus, Comments
de Med, sec, loc, lib. ix.— Aretaeus, Morb, Chron, ii. 9. — Celsus, iv, 15.—
Cslius Aurelianus, Pa3«. Tard, i v. 6.— Alexander, vii. 21., and x. 1. — Aetius,
ix. 43. — Oribasius, Synop, ix. 14., and Loc, Affect, iv. 88. — ^Actuarius,
Meth. Med. i. 41. — Nonnus, c. 167. — Octavius Horatianus, ii. 31. — Mar-
ceilus, c. 27. — Scribonius Largus, c. xi. — Averrhoes, Colliget. iv. 59.—
Avicenna, lib. iii. f. 16. tr. 2. c. 7. — Serapion, tr. iii. 26. — Avenzoar, lib. ii.
tr. I.e. 5, — Haly Abbas, Theor,i\, 26., Proc*. vii. 22. — Alsaharavius, Fract.
zvii. 1. — Rhases, ad Mansor, ix. 72., Divis. 67., ContinenSy lib. xiii.
. Hippocrates briefly describes Dysentery as being a ^complaint attended
v?ith pain throughout the whole beliy, tormina, and discharges of bile,
phlegm, and blood. The disease, he says, is occasioned by an overflow of
phlegm and bile to the veins of the belly, producing erosion and ulceration
of the intestines. His treatment consists of purging the head, emetics, open-
ing the belly, emollient clysters, and a regulated diet. In ofte of his apho-
risms he states that a spontaneous vomiting cures Dysentery.
Galen treats separately of Hepatic Dysentery and of Dysentery consisting
simply of ulceration of the mucous membrane of the intestines. Of his re-
medies some are astringents, such as galls, alum, dried roses, and hypocistis;
some anodynes, such as opium and henbane ; some are detergents, such as
myrrh, pepper, spikenard, &c. ; and some escharotics, such as arsenic, san-
darach, the scales of copper, and the like. These last are to be given only in
clysters. Modern physicians will be disposed to condemn them without a trial ;
and yet, as arsenic may be given by the mouth in properly-regulated doses,
there appears no good reason why it may not be safely administered in in-
jections, liogerius, one of the earlier modern writers, speaks favourably of
trochisks of arsenic, tr. i. c. 37. Sprengel, however, decidedly condemns-
the practice. He says of Athensus : — '^ II recommandait dans la Dysen-
teric un Lavement dont un melange affreux d'orpiment et de realgar formait
la base.'' However Boerhaave and Hoflman declare orpiment to be a safe
medicine, even when given by the mouth. At all events, it is quite certain
that the sulphurets of arsenic are much less active poisons than the oxide.
See Cleaveland's Mineral, p. 680.
Aretaeus gives a very circumstantial description of the symptoms of Dy-
sentery, but unfortunately his chapter on the treatment is entirely wanting.
He describes all the varieties of ulcers, the superficial, the deep-seated, the
irritable, the callous, and the like ; and the discharges from them, whether
thin,- bilious, fetid, devoid of smell, high-seated, or otherwise. Of the other
authorities, Alexander may be mentioned as the one who has most correctly
pointed out the importance of attending to the part of the intestines in which
the ulceration is seated. The large intestines, he says, are most commonly
afiected. He approves of bleeding in certain cases. His treatment is judi-
ciously regulated according to the exciting causes ; and, in many cases, he
prescribes gentle laxatives.
Celsus gives a very distinct account of the treatment. He enjoins rest, as
424 COMMENTARY ON THB THIRD BOOK.
all motion proves injurious to the ulcers; recommends astringent cataptasms^^
frequent washing with warm water in which vervain has been boiled, astrin-
gent food, injections of ptisan, milk, oil, the decoction of linseed, the yolks of
eggs with rose-water, &c. For drink, he directs to give tepid water either
alone or with an austere wine ; or, if these things foil, a draught of cold
water to stop the discharges from the bowels. When the disease is seated
high up, the belly is to be opened. *
Actios allows to abstract a small quantity of blood from the ann when in-
flammation is present. He says it allays heat, produces revulsion, and in-
duces sleep. Ilis internal remedies are inuch the same as those of Galen.
Much of our author's treatment is borrowed from Oribasius.
Octaviiis Horattanus, like the others, recommends, when the ulcers are at^
tended with putridity, a powder containing arsenic, quicklime, aod burnt
Eaper, administered in an astringent wine, or in a decoction of astringent
erbs. Marcellus makes mention of a similar application, which he directs
to be used only when symptoms of malignity appear.
Cslius Aurelianus gives a very comprehensive description of Dysentery,^
the principal symptoms of which are, fever, anxiety, rumbling of the belly,^
sometimes retention of urine; tongue rough, furred, and blade; tenesmus-
and pungent pains of the intestines and anus. The disease, he says, consists
of a defluxion from the belly with ulceration, and is preceded by diarrhoea,
cholera, or inflammation, Ue animadverts upon the treatment of others with
his usual freedom* Thus he blames Erasistratus for using nothing but
astringents, whereas many cases of Dysentery require laxatives. His treat-
ment is minutely detailed, but is not very different from our author's.
According to Sprengel, Nonnus is the first author who distinguishes the
white Dysentery from the red.
The Arabians follow closely the treatment of the Greeks. Injections con-
taining arsenic are recommended by Sevapion, Avicenna, and Haly Abbas.
Hhases, like Aetius, admits of venesection in certain cases. He refers the
disease in general to debility of the retentive faculty of the liver and derange-
ment of the bile. Haly treats separately and minutely first of Intestinal
Dysentery and next of Hepatic. The Intestinal, he says^ is occasioned by
ulceration of the intestines. He also describes the Bloody Dysentery, like
our author. His treatment is directed upon general principles. He racom-
mends various clysters ; and, when the ulcers are in the rectum, he directs,
among other remedies, to introduce a tent soaked in a solution -of arsenic,
quickUme, hypocistis, &c. Some of his stimulant applications, however, are
merely detergent, and do not contain septics. The ingredients of his ordi-
nary injections are either emollients or astringents, according to circomstances.
The account given by Alsaharavius is valuable but too long for my limits.
Khases, in cases of protracted Dysentery, directs to apply snow to the belly.
In fact most of the ancient authorities recommend cold applications in cases
of Chronic Dysentery. In like manner the ingenious Dr. Robert Jacksoo
affirms that he experienced great relief from the external applicatioo o£ HpKMiges
soaked in cold water and from clysters of the same. — On CM WtUerinFwcnf
p. 165. It is now generally admitted that the disease terminates in ulceratioa
or gangrene of the macous membrane of the intestines. Dr. Abererombie
questions its connexion with disorder of the liver. The French Pathologists
adhere to the ancient opinion that it is. — See the Memoir of Af. Gasfard,
Journal dc Fhys'wL Ir. 3 and 4.
GOMMBNTAKT ON THB THIRD BOOK. 435
XLIII. ON COLIC APPBCnON.
See Hippocrates, de Affect, xv. — Galenus, de Med, sec, loc, lib. «., </•
Loc, Affect, vi, 2. — AreUeus, Morb, Acut, ii. 6., Ckron. ii. 8. — Alexander^
ix. 1. — Celsus, iv. 14. — Oribasius, Loc. Affect. Curat, iv, 87. — ^Aetius, ix,
29.— 'Actoarius, Meth. Med. i. 45. — Plinius, H. N, xi. 37. — Nonnns, c. 170^.
— iSchbooius Largus. — Cselius Aurelianus, Morb, Chron, iv. 7. — MarceUus^
de Med. c. 29. — Serapion, iii. 32. — ^Avicenna, lib. iii. fen. 16. tr. 4. — Aven-
zoar, ii. 1. — Haly Abbas, Pract, vii. 28. — Alsaharavius, Pract, tr. xvii. § 2.
c. 12. — Rhases, Divit, 6^, ContinenSy lib. xxi.
Hippocrates treats very sensibly of the Colic pains which occur in summer,
recommending for then emetics of tepid mulse and vinegar, warm clysters,
the warm bath, fomentations, soporifics, and purgatives, according to circum-
stances. When the pains are seated in the lower part of the belly, he merely
gives clysters and laxatives.
. Galen gives a long list of preparations for Colic. They consist principally
of narcotics, such as opium, henbane, and mandragora, along with carmina-
tives and aromatics, as anise, pepper, valerian, cinnamon, saffron, gentian, aidl
the like.
Aretaeus concludes his chapter on Ileus with a short account of Colic. He
remarks that, the colon being a larger and more fleshy intestine than the Ileum,
the pain is less acute and the complaint in so far less dangerous. The pain,
he says, sometimes extends to the side, resembling Pleurisy ; sometimes to the
false ribs, resembling Hepatitis or Splenitis; and sometimes to the os sacrum^
tops of the thighs, and testicles. The complaint is attended with unavailing
vomiting; and what is vomited is thin, bilious, and oily. He also describes
a more protracted species of Colic among the chronic diseases. Among Uie
symptoms he enumerates torpor, loathing of food, watchfulness, and swelling
of the face. He says the pain sometimes shoots down to the testicles, whereby
ignorant surgeons have been led into the mistake of supposing that Uie disease
was seated there, and have made an incision into the Cremasters. Does he
allude to the operation for strangulated Hernia ? or does he mean to say that
the disease is confounded with inflammation of the Testicle? His treatment
of Ileus vrill be given in the next chapter.
Alexander insists strongly on the aosolute necessity of distinguishing Colic
from the diseases of the adjoining parts, which, he remarks, is sometimes
difficult. He first treats of Colic pain arising from a cold hutnour, and dis-
cusses fiilly the remedies for it. They are nearly such as our author recom-
mends, namely, attenuant food ; avoiding the common bath, which does no
good, but using the sulphureous bath, if convenient ; rubbing the a£fected
parts vtrith calefacient ointments, or applying heated bricks to them ; purging
with aloes, scammony, and the like ; using the hip-bath made with the decoc-
tions of parsley and anise, common oil, and the like ; applying epitomes ; ad-
ministering clysters of hot oil, either alone or with some carminative, such as
turpentine ; giving narcotics, as opium and henbane, when the humours are
thin and acrid, but not otherwise ; applying sinapisms and calefacient plasters ;
sometimes giving emetics ; and in protracted cases enjoining exercise. (The
reader, by the way, will find in Dr. Hosack's Edition of Thomas' Practice of
Physic some pertinent remarks on the use of emetics in Colic ; and Sydenham
details the history of a protracted case of Colic which was cured at last by
exercise on horseback.) When the disease proceeds from flatulence, he applies
dry fomentations of millet, calefacient oils, and a cupping-instrument to the
belly. When it is occasioned by constipation, he directs to remove the ob-
struction by giving water, oil, and mead, and administering the same ia
^26 COMMSNTARY ON THE THIRD BOOK.
clysters. In obstinate cases he directs to inflate the bowels with a bellows,
and afterwards to inject a little nitre and oil and water. He also speaks of
pills or pellets of lead. When it proceeds from hot and bilious humours, he
gives fur food fish, the testacea, the most indigestible parts of quadrupeds;
and recommends the common bath, and purging with drastic cathartics, such
as hellebore and scammony. When inflammation is the cause, he forbids
purgatives, because they only increase the evil, but recommends copious ge-
neral bleeding, and, if the urine is suppressed, bleeding at the ancles ; also
emollient clysters, external applications of a soothing nature, and baths after
venesection, but not before.
Celsus recommends principally dry fomentations, friction of the extremities,
and dry cupping. He also mentions a medicine called the Colic Composi-
tion, consisting of poppy tears, pepper, anise, castor, spikenard, myrrh, &c.
The beginning of Cslius Aurelianus' chapter on Colic is unfortunately
lost. He approves of venesection, fomentations of sweet oil, and injections
of the same; but disapproves of adding rue, anise, or any thing caleiacient
to them ; speaks favourably of cupping and leeching, which are to be fol-
lowed by hot fomentations with sponges squeezed out of warm water, or by
the hip-bath. As to the calefacient and acrid things usually given, namely,
parsley, cumin, and the like, he properly directs to avoid them when inflam-
mation is present. In this case he recommends the bath of oil. Wlien the
complaint is on the decline, he approves of gestation, of friction of the belly
with rubefacients, of sinapisms, calefacient plasters, and the like. He speaks
&vourably of a long sea voyage, and of the use of medicinal springs, espe-
cially sulphureous, and directs to avoid indigestion and every thing of a
flatulent nature.
Several of the other Greek and Latin authorities, especially Aetius, treat
of Colic with admirable precision ; but, as their remedial measures are much
the same as those already mentioned, we shall not attempt to give any ac-
count of them.
Serapion's divisions and treatment are nearly the same as our author's*
Avicenna, however, treats of the complaint more fully and circumstantially
than any other ancient author ; but the length of his description prevents me
from giving an abstract of it. I may mention, however, that when the pain
is violent he approves of narcotics both by the mouth and in clysters. Among
the causes of Colic mentioned by Haly Abbas is debility of the intestine, so
that it can neither digest the food nor evacuate it. Late authorities are
agreed that this is the common state of the bowels in Colic and Ileus.— ^ee
Dr. Abercrombie on Diseases of the Abdominal Viscera, It will be re-
marked that the ancients say nothing of Colic from spasm, whicby accordr
ing to Dr. Cullen^s theory, is the most ordinary cause of Colic, but which
late Pathologists have rejected as hypothetical. Haly justly remarks that the
Inflammatory Colic is the worst species of the disease ; for that in it the par
tient experiences no relief from evacuations, and the danger is imminent.
With regard to the treatment of it, he forbids to give purgatives, which do
but increase the irritation; and recommends bleeding, emollient drinks,
plasters, &c. In Flatulent Colic, his remedies are purgatives and carmina-
tives, such as hiera with anise, fenugreek, cucumber, mastich, &c. In all
cases he approves much of clysters. Alsaharavius enumerates the following
causes of Colic : — A hot intemperament, hernia, indurated faeces, cold humours
impacted in the intestines, and the presence of some poisonous medicine.
I dare scarcely venture upon an exposition of the minutiae of his treatment
When the disease is occasioned by retention of hard faeces, he recommends
oily- injections, baths^ and diluent draughts. When it arises from gross
humours, he agrees with Galen in approving of strong wine, clysters of dill,
camomile, fenugreek, and the like, boiled in water. Rhases directs to give
COHMBNTAEY ON THB THIED BOOK. 427
emetics whea the disease arises from indigestion. He probably alludes Co
Duodenal disease. He mentions alvine calculi and worms among the causes
of Colic. He particularly recommends the warm bath and clysters.
Our author's interesting account of the Epidemical Colic is copied by
Avicenna; but neither he nor any other subsequent authority supplies the
smallest additional information. The Jewish pnysician, Moyses Alatinus,
gives the following description of a Pestilential Colic resembling that des*
cribed by Paul us and Avicenna : — ^^ Colicam, Iliacamque, hujus generis,
contagwsas passioneSf quas hoc in loco refert Avicenna, memini me olim
vidisse in civitate Mantuae anno 1560, mensibus nimirum Augusti et Sep*
tembriSy quia public^ tunc temporis ejusmodi passiones contagiosa per uni-
versam civitatem grassabantur, cum ssvis symptomatibus, assiduo nempe, ac
urgente vomitu bilis porrace« in magna copia, nee non etiam sruginoss,
lipothymia, assidud, febre malignitatis non experte, ac siti immense, ac in
eftdem familik plurimi eo morbo oppressi inveoiebantur,'' &c. — Marcia
FrmUct, p. 276.
XLIV. — ON 1LBU8.
Consult the authors referred to in the preceding chapter.
Among other remedies for Ileus, Hippocrates recommends inflating the
bowels by means of a bellows. — De Morb, iii. 15.
Aretaeus gives an excellent account of the disease, the causes of which, as
enumerated by him, are, protracted indigestion of multifarious and unwonted
4bod, a blow, exposure to cold, cold drink, and prolapsus of the Intestine
into the scrotum, or Intestinal Hernia. Some, he says, die from the vio«-
lence of the pain, some from the conversion of the disease into suppuration,
and some from blackening and mortification of the bowels. The symptoms
are most accurately described. There is at first vomiting of phlegm and bile,
but latterly of fbces ; the pulse at first is rare and small, but before death it
becomes very small, very dense, and intermittent. When inflammation is
the cause of the disease, he approves of immediate venesection, so as to in-
duce deiiquium animi, which, he says, will, at all events, bring some respite
lb thie patient's sufferings. If inflammation is not present, venesection may
be omitted, and an emetic of oil and water may oe given ; and afterwardis
applications are to be used foi* promoting the discharge of flatus, consisting
of sow-bread, nitre, salts, and turpentine, which last medicine is also to be
administered in a clyster with oil, hoBcy, hyssop, and colocynth; and after-
wards another injection of hot oil and rue is to be given. Externally he
applies various fomentations and dry cupping. He gives carminatives with
anodynes and the theriac. When the bowels cannot be got opened othet-
wise, he advises to use the purgative hiera. The food is to consist of soups
made from domestic fowls, with cumin, nitre, &x:. ; and, when there is no
fever, he permits the use of hot wine.
Celsus forbids to give wine> but his treatment otherwise is like that of
Aretcus. He directs immediate venesection and cupping ; and, if the pain
be seated above the navel, he approves of emetics, but, if below, he agrees with
Erasistratus in preferring purgatives, such as ptisan, with oil and honey.
He directs to apply cataplasms from the breast to the loins, to put the patient
into a bath of oil, to inject hot oil per anum, and to use friction of the
extremities-
Our author follows Aetius and Oribasius closely, who, in their turn, are
indebted to Galen.
Nodnus seems merely to abridge our author. The causes of Ileus are said
by him to be olistruction of the bowels, inflammation, indigestion, and
428 COMMENTARY ON THK THIRD BOOK.
#
Colic aflectioDS. His remedies for children are embrocatioDs^ cataplasms,
and fomentations ; and for adults, also venesection, cupping, clysters, and
the oily bath. When the food is rejected, he recommends to give sumach and
cumin in oxymel, and also purgatives.
It appears from Cslius Aurelianus that Diocles had been in the practice
of giving a leaden bullet to swallow in this disease, no doubt with the same
intention that quicksilver is now sometimes administered. In the preceding
chapter, we have mentioned that Alexander gave pills of lead for Colic.
Cslius, however, disapproves of this practice. He finds fault with Hippo-
crates for recommending to inflate the bowels with smoke; for giving
emetics ; and for cooling the upper parts of tlie body. He himself approves
of bleeding, oily clysters, baths of oil, and the like.
The Arabians, like the Greeks, treat Ileus by venesection, clysters, and so
forth. They mention cooling plasters as an external application ; but I be-
lieve it was the practice of the ancients rather to use not fomentations tbaa
cold in this disease. Haly Abbas in general approves of venesection, but,
in certain cases arising from a cold cause, he joins Hippocrates in permit-
ting the use of wine. When the disease is occasioned by obstruction, he
recommends laxatives ; when connected with descent of the gut, he directs
to return it, but says nothing of the operation for Strangulated Hernia.
According to Rhases, the causes of Ileus are inflammation of the bowels,
debility of the expulsive faculty, and indurated f«ces.
Vegetius, the veterinary surgeon, gives an excellent account of the symp-
toms and treatment of Colic and Ileus in cattle. — MulomedicinOy i. 41, 42.
It will be remarked that several of the ancient authorities sanction the
administration of wine in certain cases of Ileus. Dr. Abercrombie relates a
remarkable case of recovery from Ileus by this practice. — Path, of the Stom.
artd Intest. p. 146. Like Aretaeus, he approves of aloes as a purgative. — Ibid,
XLV. ON AFFECTIONS OF THE KIDNEYS ; AND, FIRST, OF 8T0NB«
On these diseases consult Hippocrates, Aphor, iv. 76., de Marh, Intern,
c. 15., et alibi, — Galenus, de Med. sec, loc, lib. x., de Affect, Renum, de
Loc, Affect, y Isagoge, — Celsus, iv. 10. — Aretseus, Morb, Acid. ii. 9., Morh,
Acut, Vurat, ii. 8. — Rufi'us Ephesius, de Vesica Renumque Affectibus. —
Alexander, viii. 4. — Aetius, lib. xi. — Oribasius, de Loc. Affect, Curat, iv.
101.-«Actuarius, Meth, Med, iv. 8. — Pseudo-Dioscor. Euporist, ii. 112. —
Nonnus, c. 173. — Cslius Aurelianus, Morb, Chron, y, 4.--Scribonius Lar-
gus, c. 38. — Marcellus, de Med, c. 24. — Avicenna, lib. iii. fen. 19. tr. 1.—
Avenzoar, lib. ii. tr. 2. — Serapion, tr. iv. — Haly Abbas, Theor. ix. 34.,
Pract, vii. 42. — Alsaharavius, Pract, xx. — Rhases, Dtv. 70., and Continent,
lib. xxiii. ^
Hippocrates describes four affections of the kidneys, beginning with cal-
culus. According to his theory, stones are formed from phlegm which has
been converted into sand. — See his theory fully explained, de Morbis^ iv. 28.
He recommends fomentations with the juice of scammony, purging the whole
body, tepid baths, and the like. He intimates, however, that, when a stone
is fairly formed, the only hopes of recovery are founded upon the operation.
It appears that in his days Lithotomy was a separate branch of the profes-
sion ; for in his Oath he inhibits his pupils from performing the operation,
and binds ' them to leave it to those who make it their practice. Doubts,
however, are entertained of the genuineness of this piece. He mentions
that hairs are sometimes passed in the urine ; and the same £ict is attested
by Galen (Loc. Affect, vi. 3.), Cslius Aurelianus, Aetius, Avicenna, and
Alsaharavius, among the ancients, and by recent writers on Pathology.
COMMBNTART ON THB THIRD BOOK. 429
Galen says that all Lithontriptics are of a cutting and detergent nature, the
most of them being bitters. He makes mention of pepper, galbanum, am-
moniac, aphronitruro, asarabaoca, spignel, St. John's wort, &c.
Aretsus gives an interesting account of the affections of the kidneys and
bladder, but his remedies are similar to those of our author. For stones in
the bladder, he recommends among other things some quicklime with honied-
water, and diuretics. When a stone obstructs the passage, he directs to
push it back, or cut the neck of the bladder.
Alexander, like our author, ascribes the formation of stones to viscid and
thick humours which have been much heated or roasted. He says, in the
language of the Peripatetic philosophy, that the material cause of calculus
is a thick matter, but the efficient a fiery heat ; in like manner as by heat
and a suitable matter of such a nature tiles are formed which are insoluble in
water. This theory, by the way, is explained with great logical parade in
the Isagoge generally ascribed to Galen, but which Albertus Fabricius sup-
poses to be a work of Demetrius Pepagomenos. Alexander's remedies are
mostly the same as our author's. He speaks with surprising confidence of
the emcacy of goats' blood. His general treatment, which consists of bleed-
ing, baths, emollient and paragoric medicines, is very proper. He remarks
that certain Lithontriptics, if given unseasonably, increase the disposition to
calculus. Like our author, he forbids thick food, and attributes the best
effects to drinking water.
Those who wish to see a full exposition of the ancient views on this sub-
ject may consult Aetius. Like all the others, he says that milk, with the
exception of that of asses, contributes to the formation of stones* He also
recommends goats* blood. He gives very proper directions respecting the
regimen after extraction of the stone, to prevent a recurrence of the com-
plaint.
Celius Aurelianus makes no mention of Lithontriptics, but he describes
very properly the treatment when pain and inflammation of the bladder
supervene. It is altogether emollient and relaxant.
The Arabians treat of Calculi at great length, but have the same ideas of
the formation of them, and recommend the same remedies as the Greeks.
I remark that Avicenna, Rhases, Serapion, and Alsaharavius mention among
their Lithontriptics Barauch, or the Nitrum of the Greeks and Romans,
which was most probably an impure carbonate of soda. I need scarcely say
that this alkali is now given upon chemical principles. Like our author,
they make mention of glass as a Lithontriptic. Rhases, Avicenna, and
some of the others remark, and I think justly, that white urine is one of the
earliest symptoms of calculus. For stone in the bladder Avenzoar recom-
mends cubebs* Avicenna, Serapion, and Alsaharavius join the Greeks in
commending the small sparrow (or, as some suppose it, the wren) as an effi-
cacious remedy for calculus. It is said in the Isagoge that its Lithontriptic
powers were discovered by dreams ! Haly Abbas ascribes the formation of
stones to the concurrence of a viscid humour with heat of the part. Old
men, he says, are most subject to renal calculi ; for in them the watery part
of the urine passes down to the bladder, while the grosser part or sediment
is detained in the kidneys, and is converted into stones. Children are said
to be most liable to calculi in the bladder, owing to their eating much gross
food and taking exercise after meals, by which means the system is loaded
with gross impurities. With regard to the treatment, he enjoins restricted diet,
abstinence from gross food, and the use of medicines of an incisive and atte-
nuant nature. The general treatment during a fit of gravel is well laid down
by Alsaharavius, consisting of bleeding, cupping, the tepid bath, emollient
clysters, &c Rhases, upon the authority of Antyllus, states that stones are
formed either from drinking turbid water or from imperfect digestion, whence
^
430 COMMENTARY ON THB THIRD BOOK.
the urine deposits a sediment which is conyerted into a stony hardness l)y
the heat of the part.
Vegetius mentions that cattle, especiallj young ones, are liable to stones
in the bladder, which are apt to fall into the urethra and obstruct the urine.
He states correctly that a stone will sometimes make its way into the rectum.
— Mvdom, i. 46.
Alexander Aphrodisieus states that young and old persons are most sub-
ject to calculus. — Problem, lib. i. From the late investigations of Dr. Prout,
it appears that children until fourteen years of age are most liable to stone,
then persons after forty, while those in the intermediate period are but little
subject to the complaint.
With respect to the LithontripUcs mentioned above, all I can venture to
say is, that, having no experience of them, I do not think myself entitled to
question or confirm their efficacy decidedly ; but, as I repose little confidence
in those now in repute, I cannot be supposed to have much in those which
have fallen into disuse.
Drelincurtius discusses fireely the merits of the ancient theory of the
formation of urinary calculi, which is certainly plausible. It must be ad-
mitted that the chemical analysis of them has not thrown much light upon
tlie etiology of the complaint.
On Inflammation, Abscess, and Ulceration of ike Urinary Organs. — Cel-
sus recommends rest ; a soft bed ; opening the belly ; sitting in hot water ;
avoiding cold food and drink ; abstinence from every thing that is saltish,
acrid, and acid, and from apples ; taking copious draughts ; adding to the
(bod or drink pepper, leeks, fennel-giant, and white poppy, to promote the
urinary discharge, &c.
One may find in Galen many receipts for abscess and ulceration of the
Urinary passages, but they are similar to our author*s.
Alexander lays down the rules of treatment very properly, recommending
venesection, purging, and topical applications of a cooling nature, especially
at the commencement. When the abscess forms, he prescribes a variety of
things which are detergent without pungency.
When the bladder is ulcerated, Nonnus directs to inject into it by a
syringe honey much diluted with water, or the seed of cucumber with the
same.
The treatment prescribed by Ceelius Aurelianus scarcely differs at all from
that of the others in this case.
One of the oldest writers on diseases of the kidneys is Rufihs, who lived,
according to Suidas, in the days of Trajan, so that he vms prior to Galen,
and perhaps to Aretsus and Caelius Aurelianus. As we have seldom occa-
sion to meet with him in our researches, we shall give a fuller abstract of
his opinions on this subject than we would otherwise have done. The
symptoms of inflammation of the kidneys, as detailed by him, are pains be-
low the loins so that the patient cannot stand erect nor walk, but is obliged
to lie upon his back, which position affords him most relief; the pains ex-
tending to the bladder and testicles ; the extremities cold, more especially
the legs and feet ; frequent and painfull desire to make urine, which is at first
thin and watery but afterwards becomes redder. These symptoms are fol-
lowed by emaciation of the thighs and hips, debility of the limbs, and some-
times suppuration. His treatment is as follows : — The patient is to be laid
on a soft couch, and must abstain from food for one day, but long abstinence
is forbidden. If the belly require to be opened, this is to be done by means
of emollient clysters, such as injections of hot water, decoctions of mallows,
of linseed, or of fenugreek, to which may be added some oil. Large injec-
tions, however, are forbidden, lest they press upon the kidneys and occasion
COMMBNTART ON THX THHID BOOK. 431
irritation. When the belly in evacuated and yet the pain does not remit, the
parts may be wrapped in wool which is smeared wiih hot oil having rue,
marshmallows, dill, or mugwort, boiled in it. When the pain is acute, a vein
at the elbow is to be opened ; after which emollient cataplasms and plaaten
are to be applied to the back when the kidneys are affected, and to the fore-
parts when the bladder. When these remedies fail to remove the pain, the
loins and groins are to be cupped, and then sponges squeezed out of hot
water are to be applied, and the patient put into a hip-bath of hot water in
which poppies, camomile, and the like, have been boiled. Then, when thepa%
tient is laid in bed, let him be fomented with bladders half-filled with oil and
water ; and afterwards let cerates of the oil of privet, &c. or fragrant malag*
mata be applied. When the pain is excruciating, he directs to give a decoo*
tion containing opium and the tops of poppies. In due time diuretics are to
be administered, such as the root of acorus, ground-pine, cassia, spignel,
parsley, sea urchins, radishes, carrots, and the like. Wjien an abscess is
formed, there is a discharge of tawny and more natural urine, there is
swelling in the loins, strong heat in the kidneys, and the pain becomes duller
veith irregular fever. The abscess bursts either into the bladder or intestines.
Praxagoras, he says, related a case in which there was pus voided by the
anus for twelve years and probably longer. When it bursts into the bladder,
pus is voided with the urine. Suppuration is to be promoted by frequent
fomentations with sponges, by cataplasms of barley-meal with a decoction of
figs in mead or wine, to which*" may be added pounded wormwood, spurge,
&c. For promoting the rupture of the abscess, diuretics are prescribed, such
as vrild marjoram, mock-dittany, and the like. When the aoscess does not
burst, acrid clysters containing black hellebore, radishes, garlic, and the pulp of
colocynth are to be given. To these oil may be added, and when thus taken tn^
will promote the rupture of the abscess. However fomentations with sponges
and plasters are to be applied to alleviate the pain. When the ulcers are of
a mild nature (which is shown by the abatement of the fever and pain, and
from the substances which appear in the urine being white and inodorous),
the milder diuretics are to be used for cleansing them, such as the seed of
pompion, the decoction of dates, &c. ; or, when stronger things are required,
galbnnum, opoponax, turpentine-rosin, and the like, may be added to mead
or wine. When the ulcers are putrid, Ethiopian cumin with must, rue with
honey and wine, and the like, may be given internally ; while cataplasms of
bitter vetches boiled in wine and honey are to be applied externally. It is
proper also, he says, to inject some of the medicines for dysentery ; to give
clysters of strained ptisan ; and to place the patient in hot water. If the
matter is thick, a decoction of fennel, parsley, or wormwood is to be given.
With respect to food, he recommends milk, especially that of mares or asses,
along with honey ; also cucumbers, lettuces, the flesh of kids, lambs, and
goats, almonds, and wine; but vinegar must be avoided. All motion is to
be abstained from. When there are symptoms of repletion, emetics are to be
given. When the abscess points outwardly, he seems to direct to open it
and apply the Cautery ; but here unfortunately the text is incomplete.
This account is so full and judicious that I think it unnecessary to give
extracts from any more of the Greek and Latin authorities.
From the Arabians little or no additional information is to be derived.
Haly Abbas recommends bleeding by opening the basilic vein, and then
cataplasms of barley-flour, &c. lie then gives a cooling draught containing
the seeds of cucumbers, gourds, melons with purslain, mallows, and the
syrup of violets. This part of his practice deserves consideration. When
the abscess forms, he directs to apply cataplasms containing camomile, fenu-
greek, melilot, &c. Alsaharavius, in like manner, recommends bleeding,
cooling and demulcent draughts, the tepid bath, and discutient cataplasms.
432 COMMBNTART ON THX THIRD BOOK.
The same plan of treatment is fully laid down by Rbases. When pus i^
discharged from the bladder, owing to ulceration of it, he directs to use
BStringent injectioos prepared from galls, sumach, purslain, pomegranate
leaves, &€.
On Hemorrhage of the Kidnet/s.—OvLV author's treatment is so fully stated
that it will be unnecessary to multiply extracts from the others. It is mostly
condensed from Aetius, xi. 27. The latter makes mention of injecting in-
to the bladder some astringent infiision by means of an instrument lUie a
catheter, having a bladder attached to one extremity. When the coagulated
blood (and the urine generally does coagulate it) cannot be got otherwise dis-
charged, he recommends, like our author, to make an incision in the peri-
naeum.
Cclius Aurelianus also recommends to inject into the bladder some as-
tringent infusion, such as that of hypocistis, knot-grass, &c. In the case of
women astringent pessaries may be used.
Avicenna recommends to inject the rennet of a hare. Haly Abbas directs
to bleed, by opening the basilic vein, and then to give draughts containing
various vegetable astringents, such as wild pomegranate flowers, cucumbers,
and purslain with alum, Cyprian earth, &c. According to Rhases, the dis-
charge of blood by urine is often connected with disease of the liver.
The veterinary surgeon, Vegetius, ascribes the bloody water of cattle to ge-
neral plethora. This is a very plausible hypothesis.
On Hardness <>f the Kidnufs, — Nearly the same account is given by
Aetius, and also by Avicenna, Rhases, Serapion, and all the medical autho-
rities who have treated of this subject. Haly Abbas and Alsaharavius par-
ticularly commend the Diachylon plaster. Ruffus, as quoted by Rhases, re-
commends rest, emollient clysters, the application of cupping-instruments to
the back, tepid baths, refrigerant and sedative medicines internally.
On Diabetes. — Aretsus remarks that Diabetes is a wonderful affection,
being a melting down of the flesh into urine, occasioned by a cold and humid
cause like dropsy. The disease, he says, is of slow formation, but when com-
pletely formed speedily proves fatal. His description of the symptoms is very
striking T a 6ery thirst, a never-ending desire to make water, a parched skin,
a dry mouth, and so forth. Diabetes, he justly remarks, is a species of
dropsy, the water in the one case being determined to the peritoneum, and in
the other to the urinary organs. I have, in fact, known these diseases reci-
Srocate. He recommends by all means to pay attention to the thirst, en-
eavouring to allay it by means of the medicines <:alked Adipsa ; to rectiftr
the stomach by purging with hiera ; and to apply epithemes of spikenard,
mastich, and the like. For drink, he directs to give water in which the
autumnal fruits have been boiled-; and for food recommends starch, milk,
and cold astringent wines. He concludes by saying that the general remedies
and regimen proper in Dropsical cases will answer in Diabetes, and particu-
larly mentions the Theriac and Mithridate.
Celsus recommends exercise, friction, purging, astringent food, and austere
wine. Galen states that he only recollected having met with two cases of
Diabetes. He maintains that it is such an affection of the urinary organs
as lientery is of the bowels. He is decidedly of opinion that the kidneys are
.primarily affected and not the stomach, as some had supposed. He explains
nisTiews of the nature of the disease with great precision. — De Loeis Af-
fectisy vL 3.
Aetius has given the fullest account of Diabetes. Upon the authority of
Archigenes, he recommends at the commencement bleeding and diuretics,
the latter being given to clear away the vitiated urine from the kidneys; but,
if the disease is of long standing, he proscribes both these measures. He re-
commends also a cooling diet, ruddy wine diluted, cooling applications to
COMMENTARY ON THU THIRD BOOK. 433
the pubes and loins, and, in certain cases, narcotics, such as opium and
mandragora.
Alexander's tlieory respecting the nature of the disease is the same as our
author's, both having borrowed it from Galen. He recommends food of dif-
ficult digestion, such as the feel of oxen, the flesh of pompions, chesnuts,
&c. Ue forbids all saltish, acrid, and diuretic articles. He says nothing of
venesection.
Actuarius recommends purgatives in order to determine to the intestines,
and astringent and refrigerant remedies in general.
Avenzoar explains fully his views respecting the nature and treatment of
Diabetes, in which be follows Galen closely. But the fullest and most accurate
of the Arabian authorities on this subject is Avicenna. In certain cases, he
admits of venesection at the commencement. The remedies, however, in
which he seems to place the greatest reliance, are emetics and sudorifics,
which he gives with the intention of altering the determination of the fluids
to the kidneys. lie particularly directs to avoid taking all diuretic articles,
to use exercise on horseback, moderate friction, and, in the decline of the
disease, the tepid bath with fragr.mt wine.
Serapion gives nearly the same account as Aetius, on*y he says nothing of*
venesection. Haly Abbas states with his usual precision the theory of Galen
and the otlier Greek authorities, namely, that the disease is occasioned by a
preternatural increase of tlie attractive faculty of the kidneys arising from heat
•of the viscus. Agreeably to this theory of the disease, his remedies are re-
frigerants and astringents. Alsaharavius advocates similar views of the na-
ture and treatment of the disease. When the urine is tliick, with some ap-
pearances of blood, he recommends venesection. According to lihases, the
affection is connected with preternatural heat of the kidneys and debility of
their retentive faculty. He says it resembles lientery of the intestines.
To those who are conversant with the principles of ancient physiology, the
theory advanced by Galen, and advocated by all subsequent authorities, will
appear very plausible and ingenious^ The practice of bleeding at the com-
mencement as recommended by Aetius, our author, AvJcenna, and Alsahani-
vius, found a strenuous abettor a few years ago in Mr. Watt of Glasgow.
The ancients appear not to have known that the urine sometimes possesses
saccharine properties.
liogerius, like the ancient autliorities, refers Diabetes to a hot intempera-
meat of the kidneys, whereby their attractive faculty is increased. — ^Tr. i. 54.
A41 the earlier writers on medicine appear to have held the same hypothesis.
On Stranguria and Di/suria, — As these diseases arise from a variety of
causesy our author has properly treated of them accordingly. I do not And
that the other authorities supply much additional information.
Hippocrates mentions that there are many varieties of Strangury. His rew
medies are the tepid bath, diluent drinks, diuretics, and anodynes.
Aetius states that the disease is called Dysuria when the patient has a de-
sire and passes his urine with difficulty, and Strangury when it is passed in
drops. It is occasioned, he says, by acrimony of the urine, ulceration, or
debility of the bladder. It may also arise fpom affections of the kidneys and
liver, or from an intemperament. The treatment is to be varied accordingly.
Avicenna is particularly full upon these affections. For ardor utrina Haly
Abbas recommends various emollient and cooling articles, such as mallows,
the seeds of cucumbers, pompions, and the hot batli, &c. When it proceeds
from an inflammatory cause, he recommends the treatment directed in the
beginning of this chapter. When these remedies prove ineffectual, the Ca-
theter is to be used. He says that one of the most common causes of the
complaint is debility of the expulsive faculty of the bladder. Alsaharavius
treats fully of these complaints in much the same terms. When Dysuria is
p f
434 COMMBNTARY ON THE THIRD BOOK*
connected with inflammation, he recommends bleeding, diluent drinks, and
the warm bath. When it proceeds from a clot of blood, he directs to inject
into the bladder the water of ashes (aqua cinerumy periiaps it should be 4iqtta
ckerum), Rhases states that the complaint generally arises in old men from
heat or ulceration at the neck of the bladder. He justly remarks that, when
retention arises from inflammation, no urine at all is passed, and the pain is
constant ; and that, when connected with obstruction, the bladder gets dis-
tended.
For inflammation, pain, and ulceration of the bladder, Scribonios Largus
recommends water into which a heated iron had been plunged. He adds
that he liad known the Chalybeate waters in Tuscany do much good in dis-
eases of the bladder. This may be said to be an anticipation of the modem
practice, introduced, I believe, by the late Mr. Cline, of giving the tinc-
ture of muriated iron in such cases.
On Incontinence of Urine, — Galen properly remarks, that Incontinence of
Uiine is often occasioned by injury of the spinal marrow. — De Loc. Affect,
vi. 4.
According to Avicenna, it is occasioned by excessive cold, by relaxation of the
muscles (sphincter vesica f) or weakness of the bladder, as happens at the end
of certain diseases, or by the immoderate use of diuretics. Rhases says briefly,
that the complaint is occasioned by excessive heat or coldness. When it
proceeds from the former cause, he recommends a composition of coriander,
vinegar, Armenian bole, acorns, &c. When from cold, he directs to give the
following : — C)f dried acorns, of frankincense, q. s. to be rubbed into the
pubes with oil of ben, or oil of rue. Haly Abbas attributes the complaint to
enervation of the sphincter vesics and loss of the retentive faculty of the
bladder. He also mentions its connexion with disease of the spine. AUa-
haravius recommends various stimulant liniments externally, and galls, vine-
gar, and the like internally.
XLVI. ON AFFECTIONS OF THE LIYBR.
Consult Hippocrates, de Intern. Affect, c. 30. — Galenus, Metk, Med*
lib. xiii., Sec, Ijoc, lib. vii. — AretKus, Morh, Acut. ii. 7., Morb. Ob'on.i.
13. — Celsus, iv. 8. — ^Alexander, vii. 19. — Aetius, lib, x. c. 1. — Oribasios,
Loc, Affect, iv. 96, — Nonnus, c. 182. — Caelius Aurelianus, Pass, Tard, iii,
4. — Octavius Horatianus, ii. 13. — Marcellus, d€ Med. c. 22.— >Scribonitts
Largus, c. 30. — Avicenna, lib. iii. fen. 14. tr. l.-^venzoar, lib. i. tr. 13. —
Haly Abbas, TheorAx, 30., Pract. vii. 31. — Alsaharavius, FrtuU, tr. xviii. —
Serapion, tr. iv. — Rhases, Divis. 62., ad Mansor, ix. 67., Canttnens, xvi.
Hippocrates describes three varieties of Hepatic disease, which appear to
have been bilious fevers. It is not easy to deflne the principles upon which
his practice is directed. He mentions, however, emollient applications, bleed-
ing, purging, and vomiting ; and, when the disease is protracted, recommends
to bum the side with spindles of box-wood smeared with oil.
Galen has laid down the principles upon which inflammation of the liver
should be treated in the 13th Book of his Methodus Medendi. We can only
afford room for his conclusions. He approves of venesection with the in-
tention of producing revulsion. Such articles of food and medicine are to
be given as wilt emulge the biliary ducts without occasioning irritation, and
every thing of the opposite kind is to be abstained from. Wherefore such
things as are sweet and viscid are to be avoided, and only such as are deter-
gent without pungency are to be allowed. Of this class are ptisan and oxy-
mel much diluted. Astringents such as pomegranates are improper, be-
cause they occasion contraction of the vessels ; and they are more especially
to be avoided when the concave side of the liver is aflected. When Uie con-
COHMSNTARY ON THE THIRD BOOK% 435
vex ift ftfiected, these articles, being altered by the action of the liver before
they reach the seat of the disease, prove less prejudicial. When the concave
side is the seat of the disease, he directs to evacuate by the belly, which may
be accomplished by mixing with the food enicus (Carthamus Tinctorius,
Sprenget), the herb Mercury, &c. ; but, if stronger medicines are required,
black hellebore, colocynth, the small centaury, and the like, may be given.
When the convex side is affected, he directs to give diuretics, at first parsley,
but, afler the inflammation has subsided, the stronger ones, such as Celtic
aard, valerian, spignel, &c. Ue animadverts in strong terms upon the prac-
tice of the Thessalian Asses, so he calls the Methodists.
I regret that my limits prevent me from doing justice to the views of
Aretsus. The liver, he states, is the grand seat of sanguification, being itself
but a concretion of blood. Hence, he says, diseases of it prove speedily
iktal. Ue accounts for the pain which is fek at the top of the shoulder or
clavicle in this way. The liver, being enlarged and beaming heavier than
natural, drags down the diaphragm to which it is attached, and thereby
sCretches also the pleura from its upper adhesions, which occasions pain in
the part. A crisis, he says, may take place by a hemorrhage, a copious dis-
<^arge of bile, or of urine ; or, the disease may terminate in suppuration, or
ifi dropsy. When pus is formed, it may be discharged by urine, by the
belly, or it may poiat outwardly. In this last case, he recommends to
4>pen it with an instrument red hot, (This was the practice of the cele-
brated Baron Larrey.) When it does not suppurate it is apt to end in
scirrbus. His treatment of acute hepatitis consists of venesecttoo, refrigerant
and diseutient applications externally, cupping or leeching the side affected,
then applying cerates and emollient ointments, consisting of attenuants and
diuretics, such as wormwood, «lder, &c. The food is to be light, of easy
distribution, and diuretic. His treatment of Chronic disease is varied, ac-
cording as the matter passes by the urine or the bowels ; but the chapter on
it is incomplete.
Celsus at the commencement recommends bleeding, purging even with
black hellebore, cataplasms at first repellent and then caleracient. Diuretics
are to be given, such as thyme, hyssop, &c. ; and all cold things ate to be
avoided. When a vomica forms, it is to be opened and burnt.
Alexander's account is full and judicious. He says that, in cases of ob-
struction of the liver, when deobstruents are given before the swelling is
softened, the juices being overheated become like stones and cannot be dis-
cussed. He allndes, of course, to hepatic calculi, or gall stones. He gives
copious directions for emollient ointments to be rubbed into the side to dispel
the enlargement of the liver. By the way. Dr. Abercrombie speaks favour-
ably of Iodine ointment in such cases.
In treating of scirrhus, Aetius recommends the emollient ointments, cup-
ping, leeching, cale^aicient plasters, sipapisms, burning by medicines or by
the actual camtery.
The account given by Actuarius is in so far important, as it shows that
the views of practice had not changed in his days. In inflammation, he re-
commends to bleed two or three times, and to unite emollients with deob-
struents in the external applications.
For a full exposition of the doctrines of the Methodists, I must refer to
Cffilius Aurelianus, of whose account I can afibrd room only for a very brief
outline. The symptoms of scirrhus of the liver, as stated by him, are a
round circumscribed tumour felt below the ribs, the colour jaundiced, the
urine muddy, pain extending to the throat of the affected side, difficulty of
lying on the left side, as this posture suspends the enlarged viscus. (By the
way, Cassius assigns the same reason why persons labouring under disease
of the liver or spleen lie easiest on the affected side. — Probl, vi.) At the
pf 2
436 COMMENTARY OK TUB THIRD BOOK.
commencement he recommends fomentations, cataplasms, laxative food, and
then cupping, scarifications, and leeching. When the attack is violent, vene-
section is to be premised. Frequent changes, acrid food, and emetics with
vinegar of squills or hellebore are also mentioned. He recommends a sea
voyage, vapour-baths, &c. and various stimulant and rubefacient applications
to the side, lie delivers his strictures very freely upon the practice of the
other sects. Thus he justly condemns as too bold and dangerous a measure
the proposal of Erasistratus to lay bare the liver, and apply the remedies
direct to the part affected. He thinks Asclepiades improperly rejected gesta-
tion, baths, cataplasms, and emollient ointments. He also condemns the
free use of cauteries to the affected side.
Serapion, like Alexander, states strongly the danger of using discutients
before emollients, lest the juices become indurated. No ancient author has
treated of the diseases of the liver so fully as Avicenna. He is most minute
in liif« distinctions of disease, and particular in his application of remedies.
Among other diseased states of the viscus, he mentions diminution of bulk.
Had not iwtpecliones cadaverum been common in ancient times, the existence
of this state of diseased structure could not have been ascertained. In ab-
scessy he and Serapion make mention of taraxicum, or the dandelion, which
was recommended by the late Dr. Pemberton in cases of diseased liver, and
is still used occasionally. Haly Abbas directs, when suppuration takes place,
to determine to the kidneys by diuretics ; and, when the abscess bursts into the
cavity of the peritoneum, he advises to open it. When it makes its way to
the stomach or bowels, he recommends to promote its discharge by purging.
He remarks that sometimes an abscess will form externally to the liver and
put on the appearance of hepatic abscess. He directs to open it with aperient
medicines or the lancet. He takes notice of the pain at the top of the
shoulder, which, like Aretaeus, he attributes to the dragging down of the parts
by the heavy liver. In the cold aposteme (chronic- inflammation ?) he recom-
mends wormwood, fenugreek, hyssop, spikenard, fennel, and the like. One
of his favourite remedies for hepatic disease is rhubarb. Alsaharavius gives
a long account of these diseases. Inflammation he treats by bleeding, various
laxative and cooling medicines, emollient plasters, &c. In obstruction he gives
rhubarb, wormwood, fennel, endive, &c. ; and bleeds, if there be a sanguine-
ous plethora. He treats fully of a discharge of blood from the liver. When
it arises from the bursting of a vein after excessive fatigue, he directs to
bleed; but, when it proceeds from relaxation and debility, he recommends
astringents externally and internally. The account of hepatic diseases given
by Rhases in his Continens is particularly excellent, but it is too lengthy for
my limits. He explains the pain at the top of the shoulder in the same way
as Aretsus. He mentions that gross food- produces enlargement of the liver,
and hence animals fed on figs have large livers. For inflammation he re-
commends at first depletion and afterwards refi'igerants, such as camphor,
flea-wort, and even snow-water. He recommends aloes and wormwood as a
deobstruent cathartic.
XLVII. ON CACHEXIA.
Almost all the authors referred to in the preceding chapter may be con-
sulted on Cachexia and Dropsy.
Aretseus gives an accurate account of this aflection, which, he says, usually
terminates in dropsy, phthisis, or wasting. He mentions many symptoms of
it, such as cedema, difficulty of breathing, and so forth ; and he correctly re-
marks that the alvine discharges are dry, white, crude, and without bile. His
chapter on the treatment unfortunately is lost.
COMMENTARY ON THE TUiUD pOOK. 437
Cxlius Aurelianus says that Themison was the first who explained the
treatment of Cachexia, lie mentions as causes of the disease intemperance,
the improper use of medicines, hardness of the liver or spleen, long-con-
tinued ha:morrboidal discharge, vomiting, protracted fevers, &c. His treat-
ment is judiciously varied according to the cause of the disease, and is given
at great length.
Aetius gives a very interesting account of the views and practice of Archi-
ganes. lie says the disease is generally occasioned by scirrhus of the liver
or spleen. Like our author, he recommends bleeding if not contra-indicated,
and purging with drastic catliartics, such as the hiera from colocynth, fric-
tion, rubefacients, exercise, the bath, and thin white wines. Celsus admits
of bleeding, but not until after purging, friction, unction, and exercise have
failed to restore the health.
Serapion expresses himself in much the same terms as our author and
Aetius respecting venesection ; but Avicenna recommends not to have re-
course to it unless there be a sanguineous plethora. lie also forbids to use
baths.of sweet water, but otherwise he adopts the treatment recommended
by the Greeks.
XLVIII. — ON dropsy:
See liippocrates de Intern. Affect, c. 25., de Ratiotte Victus in Motb,
Acut. with Galen s Commentary on the same ; and almost all the au-
thors who treat of hepatic diseases may be consulted.
liippocrates gives a tolerably correct account of the causes and treatment
of Dropsy. In certain cases attended with dyspnuea he recommends vene-
section ; and Galen in his Commentary states that ihese cases are, when
the disease is preceded by suppression of the hamorrhoidal or menstrual
discharges, or is connected with plethora. But no one, he says, ventures to
bleed in tympanites or ascites. Hence Avicenna and must of the ancient autho-
rities forbid venesection in dropsy, except under the circumstances mentioned
by Galen. Galen says, indeed, in his work de Venesect, ad Erasistrat. that he
had sometimes cured dropsy by bleeding ; but it is not to be understood that
he approved of it as a common practice. In short, he was no Sangrado, but
had anticipated Blackall. Hippocrates recommends to perform paracentesis
thoracis in the side at the third rib from the last. He also approves of para-
centesis abdominis in cases of ascites; and directs to burn the region of the
liver, when that viscus is affected. He further approves of free scarifications
of the testicles and thighs. He has described hydrops uteri, or hydrometra,
a case which, although of rare occurrence, is occasionally met with. — See Van
Swieten, Comment. § 1224. — Vesalius, de Fahrka Hum. lib. v. c. 9. —
Monro's Works, and Dr. A. T. Thomson's Paper in the Med, Chir, Trans,
yol. xiii.p. 1.
Galen gives a long list of external and internal remedies for dropsical com-
plaints.— Sec. Loc. lib. ix. Ox-dung mentioned by our author was a com-
mon remedy in ancient times, according to Galen. Diogenes Laertius re-
lates that the celebrated Heraclitus died lying in a bed of it. Upon the au-
thority of Antonius Musa, Galen recommends a cataplasm containing ela-
terium, stavesacre, and hyssop. He recommends a vinous preparation of
elder. Pliny particularly commends this medicine in dropsy, and most of
the ancient authorities make mention of its diuretic properties. Our Syden-
ham speaks favourably of it in his valuable Treatise on Dropsy. Galen says
that the liver is affected in all cases of dropsy. — De Locis, lib. v. c. 6.
Celsus describes three varieties of dropsy, namely, ascites, anasarca, and
tympanites. He enjoins restriction as to food and drink ; and recommends
438 COMMBNTART ON THE THtRO BOOK.
walkiDg, friction, and sudoiifics, such as heated sand and waiin baths. He
gives a k>ng list of diuretics, as iris, Talerian, saffron^ cinnamon, Ice. In
tympanites he recommends emetics, cupping the belly, rubbing it with rube-
ntcients, and applying sinapisms to it, or burning ^K^ars on it with heated
irons. In anasarca he recommends scarifications at the inner part of the leg,,
squills in a linctus, and the like. He approves of tapping in ascites.
Aretaeus describes the symptoms of aropsy with great accuracy and ele-
gance. He says it is a most unseemly disease from which few recover,
and those more by the aid of the gods than of art. He treats of the diree va*
rieties already mentioned, and also makes mention of hydatids. He remarks
that it is wonderful how much the patient in dropsy flatters lumself with
hopes of recovery, more than in many other diseases far less dangerooB.
He states that there are partial dropsies, such as of the head, lungs, tiver^
spleen, and uterus.
From a passage in Plutarch, it would appear that certain forms of dropsy
had at one time been thought infectious. — Ve StrA Num. Vind.
Dioscorides and Ruflus praise elaterium as a hydragogue in dropsy. In the
EuporistoHf dried squills and oxymel are particularly commended, with va-
rious cataplasms externally.
Caelius Aurelianus states fully the causes of dropsy, such as cachexia, pro-
tracted fevers, hardness of the liver, spleen, peritonaeum, or uterus ; dyspncea,
coeliac affection, dysentery, retention of the hsemorrhoidal or menstrual dis-
charges, abstinence, an unseasonable draught of water, especially of salt
water, the abuse of medicines, and so forth. He maintains, however, that
the disease i» the same from whatever cause it arises. The common symp-
toms of all its varieties are said by him to be, swelling, torjpor, difficult
breathing, disturbed sleep, thirst, diminished urine, and sometimes latent
fever. He informs us that Erasistratus in his Dissections generally found
the liver indurated. His external applications are very similar to those of
our author. He particularly commends a vinous tincture of squills as a
hydragogue. He approves highly of paracentesis, and has answered all the
objections which had been made to the operation. He mentions that Asck-
piades practised scarifications at the ancles.
The ordinary causes of dropsy are well stated by Serenas Samonicus in
the following lines : —
" Ck)rrapti jecoris vitio, vel ^lenis acervo,
Cresdt hydrops, aut cum siccate febre medullte,
Aut avidse fauces gelidom hausere Uquorem.'*
Among his internal remedies he mentions broom-seeds, the wine of squills,
elder, and hellebore.
Alexander states that a coldness of the liver is the cause of dropsy, incon-
sequence of which it is no longer able to form blood, but eonvesta the fluids
into water, phlegm, or air» IJence the distinction of dropsy into ascites^
anasarca, and tympanites^ In certain cases of anasarca he permits veaesec-
tion, iu order to relieve the depression c^ the system. He add» afterwards
that, if not only the liver,^ but also the spleen smd stomach appear haed, and
especially if combined with plethora of blood, venesection is to be had re-
course to before all other remedies. But in ascites and tympanites he
agrees with Galen in condemning venesection, and trusts principMly to purg*-
ing and friction. Like our author, he commends copper and the leaves of
elder. He has stated correctly that the disease sometimes derives its origin
from the uterus.
Our author has merely condensed the account given by Aetius, His list
of diuretics contains squills, spikenstrd, alum, spurge, burnt oopper,. Ice.
Like Hippocrates, he approves highly of scarifieations at the inner ancle.
\
COMMKNTARY ON THJt THIRD BOOK. 43^
Upon the authority of Antyllus he recommesds lying in heated salt. In
like manner, Galen and some of the other authorities speak fiivoarably of
insolation while the patient lies on sand, wheat, or the like. The Sand Bath
is mentioned as a remedy for dropsy by the earlier modem writers on medi-
cinew — See Theodoricus, lib. iii. c. 33.
I do not find that Avicenna, Rhases, Avenzoar, and Serapion, make any
material alteration on the practice of the Greeks. In certain cases of aoa^
sarca they permit venesection, but generally condemn it in ascites. They
praise mezerion or the chamelsa strongly as a diuretic; and also make
mention of coloCynth and scammony. Haly Abbas treats separately of
anasarca, ascites, tympanites, and dropsy from a hot cause. When ana-
sarca is connected with an obstructed secretion, he approves of bleeding; and,
in general, recommends abstinence from drink, exercise in the sun, friction
with sand or hard towels, sulphureous baths, and diuretics. He concludes
with an advice not to persevere too long in the use of any one medicine. In
the treatment of ascites, he recommends mezerion, colocynth, &c. but disap-
proves in general of paracentesis. For tympanites he prescribes various
carminatives such as parsley, fennel, spikenara, mastich, southernwood, me*
lilot, &c. Alsaharavius expresses himself strongly in favour of venesection
for anasarca; and, for all kinds of dropsy, recommends the sand bath, su-
dorifics, and the common remedies mentioned above. The general causes of
dropsy upon which Rhases most insists are, induration of the liver, and de-
bility of the kidneys, so that they no longer attract the aqueous superfluity
of the blood. He approves of paracentesis and scarifications of the feet and
testicles when they are much swelled. Among his Hydragogues, the most
powerful are white hellebore, elaterium, scammony, and euphorbium. He
mentions that he had known several dropsical cases cured by a spontaneous
diarrhoea and hence he recommends not to stop one when it comes on.
When dropsy is connected with the retention of a natural evacuation, he ap-
proves of bleeding* He speaks favourably of the elder as a diuretic.
XLIX. ON THB SPLEEN.
Hippocrates describes several diseases of the Spleen in his work, de In^
temit Affect ionibus. He states that in scirrbus the spleen is sometimes
larger and sometimes smaller than natural. It is an affection which conti-
nues long, but is not fatal. Sometimes, he says, it terminates in dropsy,
and sometimes in suppuration, when he approves of burning the side. He
also recommends diuretics and purging with hellebore.
Aretxus remarks correctly that the spleen is very subject to scirrhus, but
little so to suppuration. Scinhus, he says, is removed with difficulty.
For scirrhous enlargement of .the spleen, Celsus recommends unction,
. friction, and sudorifics. He directs to avoid all sweet things, milk, and
cheese. He approves of pickled and salted things, acids, the vinegar of
squills, a decoction of wormwood, and water in which a red-hot iron has
been extinguished. Emollient ointments are to be applied externally.
Cffilius Aurelianus says that some had directed to cut out the spleen when
it is much diseased, but he holds the proposal as mere words of course, and
believes that the operation had never been performed.
Octavius Horatianus recommends as general remedies for complaints of
the spleen, bleeding, purging, and fomentations with wool soaked in equal
pacts of oil and vinegar. When it becomes indurated, he approves of vine-
gar of squills, friction, gestation, dropaces, salt-baths, &c.
Most of our author*s remedies are taken from Galen, who treats fully and
scientifically of diseases of the spleen. He states, as a general principle of
treatment, that the proper medicines in cases of Indurated Spleen are such
440 COMMENTARY ON THB TH1RB BOOK.
as are of an incisive and attenuant nature. He, therefofe, approves of the
mixture of bitter with austere things.
Alexander forbids strong purging in the beginning of an inflammation
either of the liver or spleen.
The Arabians treat of these affections similarly to the Greeks. Ualy
Abbas remarks that the spleen can bear much stronger medicines than the
liver, and recommends in the indolent diseases of it various bitter and very
acid medicines. In inflammation he very properly bleeds. These are his
general principles of treatment, the detail of which he explains at great
length. Avicenna and Alsaharavius treat of these diseases more minutely
than any other of the ancient authorities. Hhases recommends camel's milk
in cases of indurated spleen. He joins Archigenes in directing the applica-
tion of sinapisms and leeches to the side.
It will be remarked,, that Aretaeus- has stated that suppuration of the spleen
is a rare occurrence. Dr. Abercrombie mentions that he had only met with
one case of it. — Pathology of tlie Stomach and Bowels, p. 378. . For a judi-
cious account of both the ancient and modern opinions regarding diseases ef
the spleen, &c» see Mangeti Bibl. Chirurg, t. iii.
Lk ON JAUNDICB.
S£E Hippocrates, de Locis in HominCf c. 40. — Galenus, de Med. sec. loc^
lib. ix. — ^Aretaeus, Morb. Chron. i. 15. — Celsus, iii. 24. — Cfflius Aurelianus,
Tard. Fass. iii. 5. — Aefius, x. 18. — Oribasius, Cur. Loc. Affect, iv. 99. —
Actuarius, Meth. Med. i. 11. — Nonnus, c. 188. — Plinius, H. N. xi. 37.,
xxvi. 76., xxviii. 64. — Kuifus Ephesius, lib. ii. — Palladius, de Feb. c. 6. —
Alexander Aphrodisieus, Frobl. i. 90.— Octavius Horatianus, ii. 14. — Scri-
bonius Largus, c. 31. — Marcellus, de Med. c. 22. — Serapion, iv. 9. — Avi-
cenna,. lib. iii. f. 15. tr. 1. — Avenzoar, lib. i. tr. 14. c. 6. — Haly Abbas, Theor.
ix. 33., and Fract. vii. 41. — Alsaharavius, Fract. xviii. 11. — Rhases, Divis.
i. 64., ContinenSt lib.
The term Icterus^ according to Aretaeus, is derived from Iktis, a wild fer-
ret. The Scholiast <m Nicander says of this aninoal : — Im-ii 7 \€yofx€VTf aypia
ytArfk, And Schneider remarks in his note on this passage : — ** Britanni
equorum oeulos t^les Jerret-eyes vocant." — Theriac. \, 196. Isidorus also
says of the term :— ^' Icteiis Grseci appellant a cujusdam animalis nomine
quod sit coloris fellei."—r Orig. It is certain, from Pliny, that the Ictis and
Mustela were only different names- for tlie same animal. He says — '' Mus-
telarum duo genera : Graeci vocant Ictidas." — H. N. xxix. 16. See in like
manner Eustathius, ap. Iliad, x. 335. So much for the origin of this term
about which Dr. Mason Good is strangely perplexed.
Hippocrates directs to give at first fatty things, and to use the bath for
three days ; then to abstain from these things, and purge both the belly and
the head, and give diuretics. But he forbids cholagogues, which, he says,
only increase the disorder of the system. Perhaps there is some foundation
for this last injunction.
Our author follows closely the views of Galen. He remarks that, when
in Fever the bile is suddenly determined to the skin, it proves critical, and
is easily removed by baths of sweet water, and friction with a discutient or
rarifying oil. When the disease proceeds from obstruction of the vessels of
the liver, he directs to administer hot and detergent things such as gentian,
birth wort, and centaury. When occasioned by inflammation of the liver,
the remedies suitable to that disease will be proper. When inflammation
and obstruction are combined together, they are to be removed by relaxants
and detergents. lie gives from Andromachus and Archigenes a long list of
COMMKNTARV ON TUB T^IRD BOOK. 441
eon) positions for Jaundice ; but, we must be content with explaining his ge-
neral principles without entering upon the detail of his practice. Galen, in
another place, remarks, that the poisons of certain reptiles occasion jaun-
dice.— De hoc. Affect., lib.vi. 8. This fact is confirmed by modern obs^-
vation. — See Van ^wieten, Comment, § 916; Dr. Simson*s Paper on Jaun-
dice, vol. i. of the Medicut Essays and Observations ; and Kogerius, tr. i. c.
47. By the way, the ancients maintained that the primary action of certain
poisons IS exerted upon the liver. — See Book V. c. 42.
Aretaeus insists that jaundice is produced not only by disease of the liver
as generally supposed, but likewise by affections of the spleen, stomach, kid-
neys, and colon. When the biliary ducts are obstructed, the bile regurgi-
tates from the gall-bladder, and mixes with the blood in the liver whence it
is carried all over the body. In this case, the alvine discharges are white
owing to their not being mixed with bile. When the spleen is the seat of
the disease, the skin is of a dark yellow colour. Ue*maintains that jaundice
also arises from affections of the stomach and colon, as digestion is partly
performed in these viscera. But we will not follow out his description any
further, as it is too long for our limits.
Celsus having described the disease, directs to cure it by abstinence for*
one day, and then by opening the belly; if fever is present, the suitable re-
medies are to be applied, but otherwise scammony or bitters, such as worm-
wood, are to be given. Some, he says, cured the disease by attenuant food
and diuretics, but Asclepiades rejected the latter, and gave salt water as a
purgative. Celsus approves of a salt Greek wine, baths, and so forth. Dur-
ing the whole course of the complaint, he directs to use friction and take
exercise ; and, if it is winter, to have recourse to the bath, but in summer to
swim in the sea. He approves of all kinds of exhilarating sports and amuse-
ments, whence the disease, he says, has got the name of Regius Morbus,
Isidorus, in like manner, says of it : — ^*' Kegium autero morbnm inde esti-
mant dictum quod vino bono et regalibus cibis citius curatur.*'
Pliny directs to cure jaundice by producing perspiration with the root of
the cyclaminius or sow-bread. I have known jaundice removed by a criti-
cal sweat.
Ceelius Aurelianus says that jaundice is brought on by indigestion, or by
cathartic medicines which have been taken and have not operated. Sometimes,
he says, it is attended with enlargement or scirrhns of the liver, and some-
times, though rarely, the spleen and stomach are affected sympathetically.
If the attack is violent, he does not disapprove of venesection ; after which,
the sick are to be restored by soothing treatment, exercise, and food of easy
digestion. The accessory symptoms, such as hardness of the liver, spleen,
and stomach, are to be attended to ; and the bile is to be carried off from
the system by administering acrid clysters, and giving infusions of wormwood
or wild succory. He also approves of sternutatories such as elaterium ; of
masticatories given while in the warm bath ; and of determining to the skin
by sudorifics and medicines which produce pruritus. He also recommends
change of air, gestation, swimming in water, frequent vomiting excited by
simple means, and acrid food such as cappers, squills, &c. He approves like-^
wise of giving a thin wine, and the decoction of hellebore when the disease
is protracted ; but disapproves of the indiscriminate use of cholagogues, ca-
thartics, and diuretics, such as scammony, and colocyntb, with wormwood,
birthwort, St. JohnVwort, anise, &c. He thinks mental relaxation and se-
renity of great consequence to the cure.
Aetius gives an accurate account of the disease, but his views are very si-
milar to those of Aretaeus. He maintains that th'ere are other causes of
jaundice besides obstruction of the duct of the gall-bladder. When the af-
fertion is not critical, he directs to cure it by bleeding and purging. He says
442 COMMENTARY ON THE THIRD BOOK.
that strong purging with colocynth, scammony, and other drastics, is required
to produce revulsion from the skin. He also approves of deobstruents and
diuretics, which are to be given while the patient is in the hot bath. He
speaks of sternutatories and sialogogues, like our author. He likewise
strongly recommends emetics. — Lib. iii. 119.
The treatment recommended by Oribasius, Actuarius, Nonnus, and Octa^
▼ius, is very little different from our authors.
Kuffus, the £phesian, describes very correctly the situation and use of th^
Sail-bladder, and remarks, that when its duct is obstructed jaundice is pro-
uced, in which case the stools are white and clayey. Aetius' recoramend»'
tion of emetics is upon his authority.
Alexander Aphrodisieus states, that the constipation of the bowels in
jaundice is occasioned by the want of the natural bile, which serves as a
stimulant to the intestines. For the same reason, he adds, the stools are of a
whitish colour.
The poet Lucretius (lib. iv. 1. 333) and the philosopher Aristippus take it
for granted that persons in jaondice see every object tinged with yellow.-—
(Sextus Empiricus, adv. Math. lib. vii. § 195.) According to Dr. Mason
Good this IS sometimes though rarely the case. — {Shidy of Medicine.) I
myself have seen such cases.
According to Serapion, a redundance of yellow bile in the body is ocasion-
ed either by the system's not being properly purged of it, or by an over-secre-
tion of it, or by a combination of these causes. Obstruction, he says, may
take place either in the liver itself or in the gall-bladder. Sometimes, he re-
marks, the liver having been inflamed, becomes as hard as a stone, or its
ducts are obstructed so that the blood becomes mixed with bile, and in this
state is carried over the whole body. He adds, that perhaps the whole gall-
bladder is affected, or only one of its ducts, namely, either the superior one,
by which it receives bile from the lirer, or the inferior, by which the bile
passes down to the intestines. In like manner he afterwards states, that
sometimes the superior duct losing its tone and becoming obstructed, the
bile becomes mixed with the blood ; or, the inferior being obstructed, the bile
regurgitates to the superior, and becomes intermixed with the blood. And
sometimes, he says, the affection arises from the gall-bladder being over-dis-
tended in like manner as the urinary bladder sometimes is. When the dis-
ease is from obstruction he recommends attenuants, purgatives, emetics, and
the other remedies directed by the Greeks. A similar account is given by
Avicenna. Avenzoar says that the ducts are obstructed out verruca aut pus-
tuld. The exact signification of these terms cannot easily be determined, but
it seems probable that they refer to gall-stones. But the following passage of
Haly Abbas puts it beyond a doubt that the ancients were acquainted with
hepatic calculi or gall-stones : — *< Some,'' he says, ** relate that calculi are
formed in the liver, coecum, and colon.'' — Theor. ix. 34. Haly directs when
jaundice is connected with inflammation, to bleed, and purge with myroba-
lans, hepatic aloes, &c. He also makes mention of emetics among his
general remedies. When connected with obstruction particularly of the gall-
bladder, he recommends bleeding at the arm, a decoction of wormwood,
hiera, scammony, and various remedies of a like nature. To remove the
yellow colour of the eye he recommends the tepid bath, and the application
to the eyes of the fumes of vinegar. For the cure of jaundice of the spleen,
be prescribes the common remedies, and mentions one which he says he
learnt from a womarty and found very effectual. It was a draught containing
lentils, fennel, and the urine of a boy not come to puberty. Jaundice being
a disease which often goes off without any remedies, has been, in all ages, a
^vourite with empirics. Alsaharavius treats of the disease in much the same
termS; recommenaing bleeding when it is connected with an inflammatory
COMMENTARY ON THB THIRD BOOK. 443
caase ; and attenuants, bitters, purgatives, and the hot bath according to cir-
cumstances. Hhases, who gives a very fiiU account of jaundice, states that
the disease generally arises from obstruction either in the liver or its ducts.
He particularly recommends drastic purgatives, such as scammony, along
with wormwood, fennel seed, and the like. When inflammatory symptoms
are present he approves of bleeding and the warm bath.
Upon reference to Dr. Abercrombie's Pathological Researches on the
Stomach and Intestines^ it will be seen that the ancient account of the causes
of jaundice is upon the whole perfectly correct. like Aretsus, he states
that, the disease is sometimes produced by afiections of the bowels, especially
of Uie colon, p. 373.
LI.r-.-ON PROTRUSION OF THB NAYBL.
See in particular Oribasius, Morb, Curat, iv. 117. It is unnecessary to
multiply authorities, as all entertain similar views upon this head. The fol-
lowing is a simple receipt given by Celsus : — Cicutae et fuliginis, denar. i.;
cerusse elot», denar. iv. ; plumbi eioti, denar. viii. ; ovis duobus ; quibus
etiam solani succus adjicitur.
Haly Abbas propetly remarks that the umbilical hernia is a protrusion of
the omentum or intestine at the Navel. He recommends various astringent
plasters, containing cypress, galls, alum, &c. — Theor, ix. 36., Pract, viii. 51 .
LII. — ON DBP1LATORIB8.
Depilatories have always been made of similar ingredients to those
which enter into our author's prescriptions. The following is one from Bap-
tista Porta : — ** Constat viv» calcis partibus quatuor, redactis in pulveris
modum, auripigmenti singulari, et decoque.^ — Mag, Nat, ix. 4.
It appears from many passages in the Roman Satirists that the practice of
applying Depilatories to the obscene parts was common in ancient times.
Persius says : —
'* Ta tarn. maxMs balanatum gansape pectis,
Inguinibus quar^ detonsus gurgufio extet ? "
Sat. iv. 37.
See the learned note of Casaubon ; also, Juvenal, Sat, viii. 114., and the
note of the Dauphin Editor. The fathers inveigh against this immodest
practice. — See Tertullianus, de Pallio, and Clemens Alexandrinus, Padagog.
ii. 3.
As this subject possesses little interest now, I need not enlarge upon it.
LIII. ON BUBONOCBLB, BNTBROCBLB, AND RTDROCBLB.
As these diseases will be treated of more fully in the Sixth Book, it is un-
necessary to say much about them at present.
Our author is most indebted to Aetius, xiv. 22. Nonnus recommends as-
stringent applications of a similar nature, e. 192. When there is difficulty
of r^uction, Rhases directs to use the vrarm bath perseveringly. Haly
Abbas remarks, that protrusion of the bowels will sometimes occasion con-
stipation, pain, and death. He says nothing of an operation for relieving the
strangulation. Alsabaravius declares that he had found all the applications
recommended for the cure of these complaints utterly ineffectual after they
are fairly formed. He directs to return the protruded parts and secure them
444 COMMENTARY ON TUK THIRD BOOK.
by means of a bandage, along with a pad of lead and a plaster of pitch, &c.
The surgical treatment of these complaints is minutely described in the SixUi
Book.
LIV. — ON INFLAMMATION OF THB SCROTUM AND TESTICLE.
On diseases of the obscene parts, consult Hippocrates, Epidem. v. 4., c/
alibi. — Galenus, tec. loc. lib. ix., Loc. Affect, vi. 6. — Celsus, iv. 21., viii. 18.,
¥i. 18. — Areiaus, Marb. Chron. ii. 5.- Oribasius, Loc, Affect, iv, 10*2. —
Aetius, xi. 32., xiv. passim, — Actuarius, ilie/A. Med. i. 15., i?. 8. — Nonnus,
c. 192. — Alexander, viii. 9, 10. — Corlius Aurelianus, Jt^ass, Turd, v. 5. —
Marcellus, c. 32 — Octavius lloratianus, ii. 11. — Moschion, de Morbis Mu-
lierum. — Scribonius Largus, § 233. — Avicenna, lib. iii. fen. 20, tr. 1. and 2.
— Avenzoar, lib. ii. tr. 3^. — llaly Abbas, Theor, ix. 37., Pract, viii.— Alsa-
haravius, Fruct. tr. xxii. — Uhases, Divis. 79., ad Mansor, ix. 101., Cottti-
nens, xxiv.
Hippocrates relates a case of prurigo scroti which was removed by hot
baths, but the patient afterwards became dropsical and died.
Many of our author's remedies are taken from Galen, but he has copied
most closely from Oribasius and Aetius.
The treatment of Celsus for inflammation of the Testicles is very judicious,
namely, bleeding at the ancle, a cataplasm of the flour of beans boiled in
mulse with pounded cumin and boiled honey, and other similar applications^
When it. becomes indurated, linseed or the seed of fenugreek boiled in mulse,
or the like, are to be applied. When the testicles swell from a blow, blood
must necessarily be abstracted from them, more especially if they are livid.
Avicenna is particularly full upon these and all the other diseases of the
obscene parts. For pruritus of the testicles and scrotum he recommends
bleeckng, cupping in the vicinity of these parts, the application of leeches,
hot fomentations with acacia, sal ammoniac, &c. and the other remedies men-
tioned by Paulus. For apostemes he directs to bleed in the arm and ancle,
and to use applications similar to those of our author. Rhases recommends
bleeding in the arm and ancle, and at first cold applications, consisting of
vinegar and rose-water, which, if the complaint does not abate, are afterwards
to be exchanged for suppurative ones. Haly's treatment is nearly the same.
Alsaharavius, like Avicenna, treats inflammation of the testicles by bleeding
in the arm and ancle, and using various local applications of a cooling na-
tuie. For pruritus he recommends applications containing ceruse, sulphur,
nitre, sal ammoniac, and strong vinegar. Rhases mentions that he had an
enlargement of the right testicle for which he took an emetic, whereby a
manifest reduction of the swelling was produced, and by a repetition of this
process the complaint was entirely removed.
LV. ON GONORRHOEA AND POLLUTIO NOCTURNI 80MNI.
CCLSUS recommends strong friction, affusion of cold liquids, swimming iu
cold water, food and drink of a cooling nature, avoiding every thing flatu-
lent and calculated to engender semen, applications such as rue and vinegar
to the part, avoiding lying upon the back, and so forth.
Aretseus, in his chapter on Gonorrhoea, makes some very ingenious specu-
lations on the eflect which the semen genitale exerts upon the develop-
ment of the moral character. He remarks that a long-continued draining
of the semen sometimes occasions paralysis : he alludes, I suppose, to the
Tabes Dorsalis, a disease well described by Hippocrates. He proper-
ly states that gonorrhcea proceeds from relaxation ^f the genital organs.
COMMENTARY ON THE THIRD BOOK. 445
With regard to the treatment, he recommends at first cooling and astringent
applications to stop the flux, but these are afterwards to be exchanged for
calefacients and rubefacients. Castor, mint, and the theriac, are to be taken in-
ternally, along with strong exercise.
Galen defines gonorrhoea to be an involuntary emission of semen, arising
from debility of the genital organs, especially of the spermatic vessels.
Aetius gives a full account of gonorrhoea from Galen, and of oneirogmon
from Philagrius, but his treatment is little different from our author*s. For
the latter he directs to take such things as are calculated to prevent the format-
tion of semen, as rue, calamint, the chaste-tree, &c. and further recommends
astringent and refrigerant applications, lying on a hard bed, wearing a plate
of lead on the loins, and abstaining from the usual provocatives to venery.
Cslius Aurelianus treats oneirogmon upon much the same principles,
n.imely, by cooling applications and injections, the cold bath, astringent
food, and so forth. He makes mention of a disease of the genital organs,
which I have met with in practice, although I do not recollect to have seen
it noticed in any modern author, unless Heberden allude to it (Comment,
c. 80.) It is an emission of bloody semen in actu venerea. He directs to
treat it by astringent and restorative remedies.
For oneirogmon, the Pseudo-Dioscorides recommends an infusion of the
seed of lettuce and purslain, the decoction of nymphaea, &c. — Euporist, ii.
too. Dioscorides himself recommends hemlock.— iWie^A. Med, iv. 79.
Avicenna and Rhases follow the treatment of our author. For the onei-
rogmon, Haly Abbas recommends various refrigerant and sedative medicinds,
such as purslain, coriander, lentils, fleawort, poppies, roses, &c. For go-
norrhcea he recommends bleeding; emetics, if connected with repletion;
sleeping in a cold place ; various anodyne, astringent, and refrigerant medi-
cines, such as henbane, poppies, roses, lettuce, &c. He also directs to wear
a plate of lead over the loins. Alsaharavius treats minutely of these com-
plaints according to the nature of the exciting cause. His general remedies
for gonorrhoea are of a refrigerant and cooling nature, such as citrons, pome-
granates, lettuces, henbane, &c. with a plate of lead and other cooling appli-
cations. For oneirogmon he recommends linimentsof camphor and opium,
to lie on a hard bed, and to take refrigerant medicines. Rhases recommends
styptic applications, snow, the plate of lead, and the cold bath. He speaks
also of rubbing the parts with myrrh, henbane, and opium.
On the PoHutio Nocturni Somni referred to in Deut, xxiii. 10., see Isidct-
rus, Comment, in Deut. c. 20. Pliny treats of certain herbs which excite,
and others which dispel, the " Somnia veneris." Martial in his epigram ad-
dressed to Ponticus, expresses himself in terms of just abhorrence against the
detestable vice of manustupration. Galen, however, relates a story of it
with disgusting sangfroid.
LVl. — ON SATYRIASIS.
ARETiEus has drawn a lively but disgusting picture of a person affected
with this complaint, which it is to be hoped that the "march of improve-
ment'* in morals has now rendered of rare occurrence. He calls it a most
unseemly disease. According to his account, it will even prove fatal occa-
sionally, and that within the space of seven days. He says the natural cure of
it is a diarrhiea coming on with bilious discharges. This venereal mania, he
says, is to be cured by bleeding from the arm or ancle to deliquium aniroi,
purging with hiera, and wrapping the genital organs and adjoining parts
with wool dipped in rose-oil and wine, or in decoctions of such narcotics as
hemlock, night-shade, mandrake or poppy ; the applications in either case
446 COlfMBNTART ON THE THIRD BOOK.
being frequeatly changed. When these things do not succeed, the neigh-
bouring parts are to be cupped or leeched ; and, in case of necessity, the
albre-mentioned refrigerants are to be exchanged for cale£au:ients, such as the
oil of privet, or the Sicyonian oil. This treatment, he remarks, will prove
soothing to the nerves. He also recommends castor and a refrigerant diet,
from which wine and flesh are to be excluded. It appears, therefore, that
our author's treatment is mostly taken from him. Both say that women are
4Mibject to this unnatural disease; and, indeed, if Juvenal's account of Massa-
lina can be depended upon, she must be considered as a victim to it : —
« Tamen ultima cellam
dausit adhac ardens rigidse tentighie vulvs,
Et lassata viiis nondum satiata reeessit."
Sat. VI.
Moschion says that in women it is a prurient sensation about the pudenda
produced by manustupration, dt Morb. Mid. § 128.
Oribasius pronounces Satyriasis to be a fiital symptom in Acute Fevers
nib. vii. c. 1.;; and Prof. Sprengel confirms the justness of this observaition.
Hist, de la Med, i. ii. p. 188.
Celius Aurelianus gives a very circumstantial account of this disease. His
treatment differs from that of Aretaeus in this respect, that he disapproves
entirely of the refrigerant applications, and instead of them recommends
soothing ones, namely, emollient oils, a hip-bath of oil and water, and the
like. He approves also of bleeding, cupping, and leechixig.
Octavius Horatianus treats it upon nearly the same principles, that is to say,
he recommends fomentations witn the vapours of hypocistis or hemlock, hard
friction, exercise, and astringent food.
There is nothing original in the treatment of the Arabians. Haly Abbas
fecommends calemcient and dessicative medicines internally, such as agnus
castus, rue, cumin, &c. He also permits the use of narcotics with desiccants,
such as coriander, henbane, lettuce, and opium. To the member he directs
(o apply a cataplsism containing the oil of roses, lettuce, coriander, and cam-
phor; and, when these foil, some opium is to be added. He enjoins hard
exercise.
Alsaharavius recommends much the same treatment as our author, namely,
bleeding from the arm or foot, diluent and refrigerant draughts, cooling
applications containing vinegar, ceruse, &c. ; and, if these do not succeed,
leeches.
LVII. — ON PRIAPISM*
Many of the ancient authorities make no distinction between Satyriasis
and Priapism, but, according to Caelius Aurelianus, the former is an acute
and the latter a chronic disease. Prosper Alpinus, the modem Methodist,
says, there is this difference between satyriasis and priapism, that in the
former there is violent venereal desire, whereas in the latter there is continued
erection, but no desire nor emission of semen. It seems, in short, to be a
sort of chronic chordae.
Our author, Oribasius, Aetius, and Actuarius, follow the principles of
treatment laid down by Galen. The latter speaks of the anti-aphrodisiacal
medicines mentioned by our author.
Alexander forbids the use of such things as are of an intensely cold nature,
especially astringents and narcotics. He recommends friction, exercise of
the upper parts of the body, and abstinence from flatulent food. All incen-
tives to venery are of course to be avoided.
Avicenna agrees with the Greek audiorities respecting the anti-aphrodi-
COMMENT ART ON THE THIRD BOOK. 447
siacal properties of rue. Like they, he recommends emetics, but disap-
vDroves of drastic purgatives. When the affection is of an inflammatory kind,
Haly Abbas recommends general bleeding, cupping, leeches, and api^ica-
tions of a cooling nature, such as vinegar, purslain, solatrum, gounl, &c.
Alsaharavius recommends various refrigerant and anodyne remedies, inter-
nally and externally.
LVIII. ON IMPOTENCE.
This chapter is mostly abridged from Aetius, xi. 35.
Octavius Horatianus recommends moderate exercise, friction of the extre-
mities, and particularly of the groins, with pepper, euphorbium, and the like;
applying plasters (dropaces) of the same to me groins and loins, or making
suppositories of them ; giving flatulent food, such as rocket, pepper, and the
seeds of tares ; lying upon a downy bed ; having the attendance of females ;
and indulging in obscene reading.
See a long list of aphrodisiacal medicines in Myrepsus, § 40., and in
Avicenna, lib. iii. fen. 20. tr. 1. c. 18. In the latter I remark the nettle,
lupine, rocket, asparagus, parsley, cresses, beans, cinnamon, and an animal
called dabet aluret, which I conjecture to be the stellio or swift. Ualy Abbas
treats minutely of this affection, according as it arises from paralysis of the
part or defect of semen. In the latter case, as he considers the state of the
parts to be connected with a dry and cold intemperament, he recommends
juicy flesh, beans, vetches, svfeet wine, and so forth. He approves of a hot
bath in which violets have been boiled. He also gives caleracieBts, such as
rocket, ginger, asparagus, onions, and the like. Alsaharavius mentions va-
rious causes of Impotence. One of them is, '* excessus delectationis ad illam
qnam diligit,'' of which Mr. John Hunter relates a curious case in his work
on the Venereal Disease.
The aphrodisiacal properties of rocket are mentioned by Juvenal, SaL ix.
134. See also Pliny, H. N. xix. 6. In the following lines, Juvenal appears
to allude to aphrodisiacal friction : —
'' Callidas et cristse dittos impressit aliptes,
Ac summum dominae femur exdamare coegit.'*
Sai. VI, 421.
Athensus gives a marvellous account of the efficacy of aphrodisiacal me-
dicines.— Deipnosophy i. 11 . See the Thirty-sixth Chapter of the First Book
of this Work.
LIX. ON THINGS RELATING TO THE GENITAL ORGANS AND ANUS«
CoKSULT most of the works referred to in the Fifty-fourth Chapter.
The first part of this Chapter is almost entirely taken from Galen, sec. loc,
lib. ix ; the remainder seems to be abridged from Aetius, lib. xiv. Galen
(Meth. Med. v. 15.) insists strongly that diseases of the penis should be
treated with Desiccative instead of Epulotic applications.
No ancient author has treated so fully of diseases of the genital member as
Celsus, vi. 18. His description of the ulcers upon it is very minute. Ul-
cers, lie remarks, are found either upon the prepuce, or on the glans, or be-
yond it on the member itself. If dry, they are first to be bathed with warm
water, and then lycium (catechu ?) out of wine, or the lees of oil boiled with
the same, or butter with roses is to be applied. If there is a slight discharge,
they are to be washed with wine ; then honey and a fourth part of turpen-
tine-rosin are to be added to the butter and roses for an application. When
448 COMMENTART ON THE.TH1RD BOOK.
there is a purulent discharge it is to be washed away, and the part dressed
with an application containing pepper, myrrh, saffron, and misy, boiled in
austere wine to the thickness of honey, lie mentions various other escharo-
tics containing serugo, alum, and the like. When at any time inflammation
oomes on, a cataplasm must be applied. Spreading ulcers are to be treated
with applications containing the escharotics we have just mentioned. When
a watery sanies runs from Uie sore it is to be treated with basil icon (tretra-
pharroacon) melted with roses and some frankincense ; and it is to be fre-
quently bathed with hot water and covered up from the cold. The tubercles
called phymata are to be burnt down with medicines or a cautery of iron,
and when the crust falls off, the squama sens is to be sprinkled on the part.
Cancerous sores are to be extirpated by escharotics, as by a composition of
quicklime, chalcitis (sulphate of copper?), and arsenic; or, they are to be
cut out and the part burnt. Phagedarnic sores in like manner are to be
burnt with medicmes or the actual cautery.
Avicenna approves of Galen*s rule of treatment stated above. When sores
are recent, he recommends in particular aloes, and when more humid, burnt
x>opper. When an incarnant is required, frankincense is to be mixed.
Prurigo is to be cured by venesection, purging, and liniments containing
nitre, alum, sal ammoniac, or even stavesacre with vinegar or rose-oil. For
prurigo Alsaharavius recommends lotions of sea' water, decoctions of camo-
mile, saffron, and camphor pounded with vinegar, and the like applications.
For hard pustules he recommends various corrosive applications, some of
which contain arsenic. Ualy Abbas remarks that ulcei's on the genital mem-
ber are attended with the same symptoms as those on other parts.
On Diseases of the ^nt^ .-r-Celsus has likewise treated very fully of these
complaints. For rbagadia or fissures he recommends first the hot bath, and
afterwards cooling ointments, such as old oil with litharge, and unwashed
wool spread with a composition of liquid cerate and roses. Thd regimen is
thus tersely pointed out:-^'*Liquida, lenia, pinguia, glutinosa, meliora sunt.''
The tubercle called condyloma, is said to derive its origin from inflamma-
tion, and is to be treated at first by making the patient stit in a hip-bath of
water having vervain boiled in it; and then lentil with some honey, or a com-
position containing chalcitis, or aium with ceruse and litharge, or the like,
is to be applied. If these do not succeed, the escharotics, such as verdigris,
antimony, &c. or even the more powerful caustics are to fate used. He treats
haemorrhoids upon much the same plan as our author. He begins by incul-
cating that there is danger in suppressing them suddenly. They ai*e to be
treated at first upon the soothino^ plan, by baths, emollient applications, and
those directed for fissures. When these fail, strong caustics are to be ap-
plied, such as the composition consisting of arsenic, squama seris, and quick-
lime. Next day they ar^ to be pierced with a needle. In certain cases be
prudently directs to bleed from the arm. Procidentia aui is to be treated in
first place by fomentintr the gut with austere wine and the like, and replacing
it ; and then applying tl>e leaves of willow boiled in vinegar, a linen com-
press, wool, and a bandage. Fungous ulcers he directs to bathe with tepid
water, if in winter, or with cold if at any oiher season ; aud then to sprinkle
them with squama aeris, or dress them with a cerate containing the same
with quicklime, &c. If these do not succeed, the parts must be burnt with
Potential or Actual Cauteries.
Galen remarks that diseases of the anus are difficult to cure, because the
part is possessed of great sensibility, and is exposed to be irritated by the
alvine discbarges, which contain bile, ichor, and the like. Styptic substances,
which do not produce moch irritation, are most proper for them, such in
particular are many of the metals. He gives a long list of applications re-
commended by Andromachus, Asclepiades, and others, the principle ingre-
COMMENTARY ON THE THIRD BOOK. 449
clients of which are ceruse, litharge, alum, rose-oil, and tlie like. For proci-
dentia ani he recommends various astringent applications containing galls,
sumach, roses, pomegranate rind, burnt lead, litharge, &c.
Aetius gives a long account of these complaints, but we must be content
with a brief summary of it. He treats procidentia ani in the first place
with astringent applications, containing galls, hypocistis, austere wine, and
the like; but, when these things do not succeed, he directs to burn the
verge of the anus with the Actual Cautery. Hemorrhoids he advises to ex-
tirpate with the knife ; but, when the patient will not submit to this opera-
tion, he directs to burn them with caustics, such as arsenic, quicklime, and
the like. He recommends various combinations of these medicines for con-
dyloma, acrochordon, and thymus.
Octavius Horatianus may be consulted with advantage ; but, as his general
plan of treatment is not very different from that of Celsus, we shall not give
an abstract of it.
For Rhagadia Marcellus recommends a composition of litharge and rose-
oil. He gives an interesting description of the process of curing hemor-
rhoids by an application containing arsenic, chalcitis, misy, and the like. I
am decidedly of opinion that this plan of treatment merits consideration. It
is strongly recommended by the Pseudo-Dioscorides. He says that a mix-
ture of equal parts of arsenic and sandarach will make them drop off in half
an hour. — Eupor, i. 214.
The Arabians treat these diseases upon the same principles. Avicenna
describes three kinds of hemorrhoids. The first kind are like warts ; the
next are of a bloody nature ; and the third are intermediate between Uiese.
He treats them, like the others, either by a surgical operation, or by power-
ful caustics containing arsenic, quicklime, and the like. When hemorrhoids
are gross, and do not yield to ordinary treatment, Haly Abbas directs to
apply septics*, such as arsenic, quicklime, &c. ; and, when they become black,
to dress them with ceruse ointment, or a mixture of rose-oil and the whites
of eggs. Procidentia ani he treats, like Celsus, with astringents, such as
galls, hypocistis, recrementum ferri, &c. For fissures he recommends emol-
lient ointments . containing ceruse, basilicon, wax, &c. Alsaharavius also
approves of septic applications containing arsenic, .Sec. When the piles are
ola and callous, however, he prefers the surgical operation. He also pru-
dently recommends to give gentle purgatives. Rhases directs in cases of
procidentia ani, when the anus is swelled, and the gut cannot be got readily
replaced, to put the patient into a warm bath and use emollient applications;
afterwards astringents are to be substituted and a bandage applied. He re-
commends to extirpate hemorrhoids vnth the knife, the cautery, or caustic
medicines; but advises to bleed in the first place. He says that, when
dressed with sandarach, they speedily drop off. In prolapsus, when the
anus is swelled, he directs to bathe the parts with a decoction of mallows,
&c., then to smear them with mucilaginous substances ; to replace the gut,
and secure it with a bandage.
The primary sauce mentioned in this chapter of our author is thus ex-
plained by Lister : — *' Liquamen optimum^ Istud garum a Paulo ^gineta
vocabatur npoyrfwv, sen primarium, quod nobilissimum illud esset/' — Ap,
Apicium, vii. 6. It was called Garum Nigrum and Garum Sociorum by tn«
Romans.-— Galen, Med. sec. loc, lib. iii. It is thus described by Martial :-^
** Expirantis adhuc scombri de sanguine prime,
Acdpe fastosum munera cara garum."
Jn the Geoponics it is<:alled Garum Hsmation.— Lib. xii.
fi S
450 COMMENTARY ON THE THIRD BOOK.
LX.-— ON DIBBASB8 OP THB UTERUS ; AND, FIRST, OF MENSTRUATION.
The fbllowiog is a list of the ancient authors on midwifery : — Hippo-
crates, de Natvru Muliebrif de Morbis Muliemm^ de Sterilibus. — Galenus,
de Med. sec. loc, lib. ix., et alibi, — Aretaeus, Morb. Chron. ii. 11. — Oriba-
sius, Med. Collect, lib. iv., Synop. lib. ix. — Kuflus Ephesius, lib. i.'^-Actua-
rius, Meth. Med. lib. iv.— -Aetius, lib. xvi. — Nonnus, c. 103.-»Celsus, lib.
iv. — Octavius Hoi-atianus, lib. iii. — Pseudo-Dioscorides, Euporist, ii. 80.—
Moschion, de Morb. Mulier* — Marcelliis, de Medicam. lib. xxxiii. — Eros,
apud Gynacia. — Plinius, if. N. lib. xxviii., lib. xxx. — Avicenna, lib. iii.
fen. 21. — Serapion, tr. v. — Avenzoar, lib. ii. tr. 5. — Averrboes, Coliig.iv.
60. — Albucasis, Chirurg. lib. ii. — Haly Abbas, Theor. ix. 39., Pract. lib.
viii. — Alsaharavius, Pract. tr. xxv. — Khases, ad Mafuor. lib. ix., Continent,
lib. xxii.
The ideas entertained by the ancients respecting the natare of the men-
strual discharge may be best learned from Aristotle, de Generat, Animal.
lib. i. 19. My limits will not permit me to do justice to his theory of con-
ception. It may be proper to state, however, that he holds the menses to
proceed from a sanguineous superfluity {ntptmapLo) in the system. This
theory found a strenuous advocate in his great commentator, Averrboes
(Coitig. iii. 29); and Buffon's views on this subject are very little different.
Hippocrates, in like manner, taught that the male semen is a superfluity col-
lected from all parts of the body. — De Aere et Aguis. Pythagoras called it
the froth of the blood and the superfluity of the aliment. — Plutarch, de Pla^
citis Philos. v. 3.
Dutens gives a learned account of the ancient theories on the generation
of animals. Suflice it to say, that Empedocles, Hippocrates, Aristotle, and
most ot the philosophers, taught that all animals derive their origin from ova ;
but ttiat Democritus and a few others maintained that they are produced
from spermatic animalcules.
It appears to have been the popular belief in ancient times, that the moon
exercises a certain influence on the womb ; and hence Homer refers the sud-
den deaths of women to Diana. — See Eustathius, ap. Iliad, xx. 59.
LXI. ON SUPPRESSION OF THE MENSES.
One may 6nd in Hippocrates a long list of medicines possessed of real
or imaginary virtues as eromenagogues ; such as cantharides, myrrh, paeony,
cumin, elaterium, squills, the fruit of juniper, seseli, thyme, St. John^wort,
rue, castor, elicampane, nettle, sage, &c. Of these some were given by the
mouth, and others applied upon pessaries. He also recommends fumiga-
tions with aromatics. The pessaries were supposed to be likewise capable of
producing abortion, but Hippocrates, in his Oath, forbids to give them to
pregnant women. It appears from Juvenal that foeticide was a very common
practice in his time (see Sat. vi.); and various methods of performing it are
described by Avicenna (lib. iii. fen. 31, tr. 2.), which I forbear to explain,
lest my pages should be instrumental in increasing the frequency of this dis-
gusting crime.
Although Galen has treated very fully of this disease in different parts of
his works, and has explained satisfactorily the nature of emmenagogues, we
shaU pass him by on the present occasion, in order to afford us more room for
doing justice to the views of Aetius, whose account of amenorrfacea I consider
decidedly the best I have ever met with. Aetius says that barren and pregnant
women, singers, and dancers, do not menstruate, the menstrual superfloity in the
COMMENTAllY ON TH£ TU1U1> BOOK. 451
Utter being consumed by too much exercise. It is undoubtedly true, as he re-
marks, that those who take strong exercise have less discharge than women
who lead an indolent life. Sometimes too, he says, a fat or lean state of the
body will occasion suppression of the menses, because fat persons have too
little blood in their vems, it beinp: consumed in forming the fat; and hence
too they seldom conceive, or, if they do, their offspring is puny. In those
too who are much emaciated the necessary sanguineous superfluity is want-
ing. The menses may likewise be suppressed from disease, such as loss of
blood, profuse perspirations, vomiting, purging, or cutaneous eruptions.
Callosities, cicatrices, and other diseases of the uterus will likewise occasion
suppression. His treatment is judiciously varied according to the cause of the
complaint. Suppression, he says, brings on heaviness, torpor, pam of the loins,
of the hind-head, of the root of the eyes, &c. When suppression arises from
a hot temptra/nentf it is to be treated with cooling and diluent food, such as
ptisan, milk, lettuces, domestic kids and lambs, tender fishes and fowls,
grapes, cucumbers, and a white watery wine. Baths of common water are to be
used. When connected with a cold temperament, the patient is of a pale leaden
colour, and her urine watery. She is to live upon food of a heating nature,
with a generous fragrant wine, or the wine made with salt water, and must take
active exercise. The suitable medicines are those of a calefacient nature,
such as thyme, calamint, cassia, spikenard, or savin, taken in a white old
wine. He also recommends myrrh, assafcetida, opoponax, castor, sage, rue,
cumin, and the like, all of which are to betaken immediately after the bath;
and, when these do not succeed, he directs to purge or give an emetic. Pes-
saries too may be used, but the more acrid substances such as elaterium,
cantharides and white hellebore, must be rejected, as they are apt to occa-
sion irritation and inflammation. Of his long list of prescriptions for pessaries, I
shall merely notice the one consisting of turpentine, myrrh, honey, and saffron.
When occasioned by J'atnesSf the principal reliance is to be put upon an atte-
nuant diet, but suitable fomentations and potions must not be neglected.
Guarded purging with drastic cathartics, such as scammony or spurge, has
often a good effect. Strong pessaries are likewise proper. When the sup*
pression is connected with plethoroj the patient experiences pains about the
loins and lower part of the belly at the accustomed period, and a marked
fullness of the veins is perceptible. It is to be cured by copious bleeding
either from the arm or foot, by quietude, and the use of common fomenta-
tions. Restriction as to the bath and food must be enjoined. When con-
nected with emaciation, the constitution is to be recruited by suitable exer-
cise and regimen, not neglecting pessaries and potions. When occasioned
by vitiated humours, such as bile or phlegm, the body is to be purged with
the proper medicines, and the parts fomented. Fragrant articles are to be
mixed with the food. The pessaries are to be made of elaterium, sow-bread,
or the like, if bile prevails; but of anemone, pepper, or colocynth, if phlegm.
When a bleeding at the nose is the cause of suppression, it is to be cured
by sweating, vomiting, or other evacuations. But in this case, and when
the suppression aiises from barenness or excessive labour, no marked incon-
venience is felt, only conception cannot take place. When occasioned by an
indolent course of life, the proper remedies are suitable labour, exercise, ges-
tation, a thin white* wine, and heating, attenuant, and humid food. When
the complaint is not connected with any of the causes or states above de-
scribed, it is to be presumed that it is occasioned by some organic disease,
which must be treated accordingly.
The same subject is well treated of by Avicenna, but I cannot afford room
for even an outline of his account. Like our author, he approves of tight
ligatures around the thighs, bleeding from the saphena ; and among his em-
menagogues I remark savin, musk, castor, and myrrh. All these occur
2 G g
452 COMMENTARY ON THE THIRD BOOK.
also in Serapion's list. Ilaly Abbas recommends baths medicated with
various stimulant articles, such as fennel, rue, camomile, parsley, &c. He men-
tions pessaries and suppositories, or tents prepared with attenuant and stimu-
lant medicines, such as myrrh, wild marjoram, rue, savin, hellebore, colocyntb,
wormwood, bull's gall, &c. He also speaks of fumigations with the vapours of
aromatics, such as castor, olibanum, lignum aloes, &c. He approves of
bleeding from the saphena, and of applying cupping-instruments to the thighs,
especially when there is any determination to the nose. When connected
with corpulence, he enjoins strong exercise, attenuant food, restricted diet,
and purgatives. Alsaharavius treats fully of this complaint upon nearly the
same plan as Aetius. He says the stronger emmenagogues are wild mint,
juniper, black hellebore, mastich, myrrh, colocynth, gentian, &c. To re-
lieve the pains which sometimes precede menstruation, he recommends the
tepid bath, moderate exercise, and attenuant food. Rhases recommends
bleeding at the ancle, savin, purging with hiera, black hellebore, &c ; pes-
saries of the same, the hot bath, and stimulant friction.
Eros strongly recommends repeated bleeding at the ancle, the tepid bath,
purgatives, diuretics, and emmenagogues, such as savin, calamint, myrrh, &c.
LXII. ON IMMODERATE MENSTRUATION AND UTERINE HE-
MORRHAGE.
Aetius gives a very full acount of these complaints but nearly in the same
terms as our author. He condemns the practice of applying sponges soaked
in cold posca, because, he says, they prove injurious to the uterus by pro-
ducing too much coldness. Galen remarks that pregnant women have some-
times discharges of blood from the veins of the os uteri. I can attest the
correctness of this statement.
Oribasius and Actuarius treat these complaints like our author.
Octavius Horatianus directs to subject the parts to the vapours of such
astringent articles as pomegranate rind, roses, and galls ; or to apply to the
parts a sponge soaked in posca, or wool squeezed out of some of the styptic
juices. He also recommends to produce revulsion by means of cupping-in-
struments applied to the breasts. He further directs to apply to the parts
epithemes of astringents, especially Theban dates boiled in wine or vinegar.
Moschion gives a very sensible account of uterine hemorrhage, for which
he recommends perfect quietude and sponging with cold water and vinegar,
or, if that fail, with astringent decoctions, &c.
Rhases recommends venesection (but does not point out the cases in
which it is applicable) ; astringent trochisks containing the recrementum
ferri ; cupping-instruments applied to the breasts ; stuffing the vagina with
wool smeared in a mixture of frankincense, wild pomegranate flowers, galls,
antimony, acacia, and alum. He also recommends epithemes, and, when
these things do not succeed, pessaries made with escharotics. In uterine
hemorrhage after delivery, he recommends cold astringent applications, and to
bind the extremities. Haly Abbas correctly remarks, that uterine hemorrhage
sometimes proceeds from plethora of the system, in which case he properly
recommends bleeding. When connected with thinness of the blood, he directs
to give incrassant food. He also makes mention of the usual astringent ap-
plications consisting of galls, vinegar, and the like. Serapion and Alsaha-
ravius lay down similar rules of practice. Avicenna, however, is the fullest
of the Arabian authorities upon menorrbagia. Like Haly, he states that it
sometimes proceeds from plethora, when he recommends to produce revul-
sion by bleeding at the arm. When connected with debility, he directs to
use astringents. When it proceeds from ulcers, he approves of a combina-
COMMBNTART ON THE THIRD BOOK. 453
tioD of agglutinative, astringent, and narcotic medicines. His general treat-
ment during an attack is almost the same as that recommended by Paulus.
He mentions acidulated water, vinegar, camphor, alum, galls, &c. Some
of his prescriptions contain opium, which is an anticipation of the modern
practice. In addition to the evidence in favour of opium for uterine hemor-
rhage, which is contained in our presently popular works on Midwifery, the
reader will find the practice strongly advocated by Boerhaave and Van
Swieten. (Comment. § 1307), and by Riverius, (Prax. Mtd. lib. xv. c, 21^.
I have seen the propriety of it questioned lately, but, as I think, upon insuf-
ficient grounds. Opium in this case probably operates by retarding the ac-
tion of the heart. That opium has this power is clearly proved by the ex-
periments of Alston and Whytt on Frogs. — Medical Essays and Observations ,
t. ii. and v. Stentzel further mentions that opium acts by coagulating the
blood. — De Somno, c. 19. See our Notes on the Forty-second Chapter of the
Fifth Book.
LXIII. ON THE FEMALE FLUX.
By the term Female Flux Ruffus describes the complaint now called the
Whites; but our author applies it to any vitiated state of the menstrual dis-
charge. Ambrose Par^ uses it in this extended signification.
Hippocrates has given a very good description of the symptoms which
sometimes attend leucorrhcea, namely, swelling of^ the face, paleness of the
countenance, enlargement of the belly, anasarca of the limbs which pit upon
pressure, short breathing, debility, and so forth. He admits the difficulty of
curing such complaints, but directs to attempt it with diuretics, epithemes,
masticatories, a desiccative diet, and exercise. He details many interesting
histories of the complaint.
The account which Aretaeus gives is nearly the same as our author's. It
is sometimes, he says, attended with a white discharge, and sometimes with a
red, of which there are several varieties. It occurs at irregular periods, and in
some instances when it continues long it will prove fatal by hemorrhage.
The symptoms are various according to the nature of the discharge. His
chapter on the treatment is lost.
Aetius has treated of the Red Flux and of the White separately. When
the discharge is red, he begins with venesection, and then applies to the
parts sponges soaked in astringent decoctions, the preparation of which he
has described at great length. When the discharge is white, he recommends
gestation, vociferation, walking, friction, and applications which are both as-
tringent and detergent. Galen correctly remarks, that women of a loose phleg-
matic habit of body are most subject to the Whites.
Oribasius and Nonnus are little different from our author.
Octavius Horatianus approves of an astringent and desiccative regimen.
He advises to produce vomiting frequently with radishes, to use exercise
gradually increased, to change the air frequently, and to apply depilatories,
calefacient plasters, and sinapisms to the part. If the discharge is copious
and attended with pain, he advises to bleed.
Eros recommends fumigations with the vapours of various herbs, after
which calefacient oils are to be applied upon wool to the part.
The works of the Arabians contain nothing remarkable on this head. Haly
Abbas recommends venesection when the discharge is bloody ; but, if it con-
sist of other humours, he directs to administer medicines which promote
their discharge; and also to use astringent and stimulant pessaries. Alsaha-
ravius recommends the same medicines, and likewise in particular the warm
bath.
454 COMMENTARY OX THK THIRD BOOK.
LXIV. — ON INFLAMMATION OF THE UTBRU8, AND ON CHANGE OF
ITS POSITION.
Aetius has given from Pbilumenus a very circumstantial account of the
lyroptoms and treatment of Inflammation of the Uterus ; but, upon the whole,
it is little different from our author's. He also gives from Aspasia a fuller
account of deranged position of the uterus. Without doubt he alludes to re-
troversion and anteversion of the uterus, as they are called in modem works
on Midwifery. These cases generally occur in the first months of pregnancy,
but there are instances of their happening in the unimpregnated state. — (See
Burns' Midwifery , book i. c 19.) The symptoms, as described by Aetius,
are sufficiently well marked : retention of the fa?ces, owing to the rectum
being obstructed by a tumour; pains in the region of the pubes, and sometimes
retention of urine. He directs to draw off the water by means of a catheter,
and to bleed, give emmenagogues, and apply pessaries, according to cir-
cumstances. Avicenna and Haly Abbas make mention of malposition of
the womb, but they appear to have derived all their information from
Aetius.
We shall give a brief outline of Serapion's treatment in cases of uterine
inflammation. He properly begins with bleeding first from the arm, and
afterwards at the ancle. He then gives a laxative medicine, and applies a
plaster to the region of the uterus. VVhen the complaint is at its acm^, he
directs to use fomentations prepared by adding sedatives to such medicines
as pomegranate rind, endive, fieawort, fenugreek, camomile, and dill. When
the inflammation does not abate, he directs to encourage suppuration by the
combination of maturative with calefacient medicines, such as a plaster con-
taining fenugreek, barley flour, figs, pigeon's dung, &c. Haly's plan of treat-
ment is little different : — General bleeding according to circumstances ; cool-
ing draughts composed of purslain, violets, spinage, &c. ; plasters of violets,
camphor, &c.; hot baths prepared with melilot, mallows, linseed, &c. When
there is heat in the parts, he directs to introduce oil of roses, with the whites
of eggs, the grease of hens, &c. to which opium may be added. When the
pain is violent, he particularly recommends to use cooling injections. Alsa-
baravius recommends bleeding from the arm and at the ancle, diluent and
cooling draughts, local applications containing opium, seed of fenugreek,
plantain, house-leek, &c. and the tepid bath.
Khases says that, when the womb is displaced, there is vehement pain with
distention of the parts, the woman cannot rise nor sit but with difiiculty,
the urine is retained and sometimes the feces. He directs to restore the
uterus to its position by drawing its mouth in the opposite direction. Mal-
position of the womb is also briefly noticed by Hippocrates, de Morb.
Mulur. lib. i. and by Dioscorides, Meth, Med. i. 37.
LXV. ON ABSCESS OF THE UTERUS.
Oi;r author abridges the account given by Aetius, but has omitted some
things of importance. Aetius directs, when the abscess is forming, to apply
fomentations by introducing a piece of sponge into the vagina, and to
steam the uterus by means of a tube calculated to convey the fumes to it.
When the pain is violent, poppy heads are to be added to the cataplasms.
The poppy is an ingredient in several of the cataplasms mentioned by Sera-
pion. Avicenna's treatment is perfectly similar. Oribasius remarks that an
abscess may burst by the os uteri, the bladder, or into the rectum. WTien
it makes its way into the rectum, Haly Abbas directs to use clysters com-
COMMUNTARY ON THB THIRD BOOK. 455
posed of such articles as lentils, pomegranate flowers, Armenian earth, rose-
oil, ceruse, dragon's blood, gum arabic, the yolk of an egg, and vinegar.
His general treatment consists of pessaries, plasters, injections into the
vagina, and clysters of various cooling and emollient articles.
LXVI. — ON ULCERATION OF THB UTERUS.
Our author has described the treatment of ulcers in the womb so fully
and judiciously, that little of importance can be added to it. It is mostly
compiled from Aetius, who, in his turn, professes to have copied from Archi*
genes, Aspasia, and Asclepiades.
Aretaeus says that of ulcers in the womb some are broad, attended with
pruritus and a discharge of thick matter without fetor. These are not
dangerous. But, when the discharge is thin, ichorous, and foetid; when the
lips of the sore are callous; and when it spreads like a phagedaenic ulcer; it
is of a malignant kind. His chapter on the treatment is lost.
Unfortunately there is also a hiatus in the text of Celsus, which detracts
from the value of his account.
Octavius Horatianus recommends a potent remedy for putrid ulcers of
the uterus which supervene upon wounds. It is a trochisk formed of arsenic,
quicklime, sandarach, burnt paper, and the like. Although the case re-
cently reported of the man who killed his wife, by introducing into her vagina
the oxyd of arsenic, ought to teach us caution, I can certainly conceive that
such an application, if properly managed, might prove safe and effectual. It
ought also to be kept in mind that the orpiment of the ancients was less
virulent than the arsenic of the moderns.
Scarcely any additional information is to be learned from the Arabians.
The following application recommended by Avicenna seems to be a Judicious
one: — ^Take equal parts of litharge, ceruse, and sarcocolla ; make a cerate
with wax and rose-oil. When the ulcers are attended with a bloody dis-
charge, Haly Abbas directs to use pessaries and injections of an astringent
nature, consisting of galls, hypocistis, plantain, rose-oil, and the like. When
the discharge is whitish and purulent, he recommends the tepid bath and
injections of barley gruel, honey, &c. For relieving the pain, he recom-
mends an ointment containing litharge, frankincense, axunge, fresh butter,
strained wax, and rose-oil. Alsahai*avius recommends similar remedies.
LXVII. — ON CANCER.
Hippocrates, de Morb. Mulier. ii. 24., gives a long account of Cancer of
the womb, which, wlien fairly formed, he pronounces to be utterly incur-
able. He directs, however, to try the effect of fumigating the womb by in-
troducing into it a pipe attached to a pot. Steams from garlic and the fat
of seals are to be applied in this manner.
Aetius gives from Archigenes exactly the same account as our author.
Aretseus describes the ulcerated cancer, and that kind in which there is no
ulceration. He calls them chronic and fatal diseases.
Haly Abbas pronounces the disease to be incurable, but directs to soothe
the suflferings of the patient by various anodyne preparations. For this pur<->
pose he gives directions for the formation of several pessaries and injec-
tions, the principal ingredients of which are linseed, camomile, fenugreek,
coriander, beet, poppies, and the like. Alsaharavius also approves of such
anodyne applications. Rhases directs to abstain from every thing of an acrid
nature, and such as engender black bile.
456 COMMSNTARY ON TUK THIRD BOOK.
We will bee the treat meot of cancers in general detailed in the Fourth-
Book.
LXVIII. ON SGIRRHUS AND 8CLBR0MA.
Our author's account of these diseases is>tak«n from Aetius^ who professes
to copy from Soranus the Methodist. None of the other authorities has
treated of them so fully. Bernard justly remarks (Af>. Nonnf £p. c. 208.)
that, if the ancients had not been familiar with insp4cli9ne8 cadaveruniy they
could not have described the diseases of particular parts of the uterus so- ac-
curately as they have done. Actuarius brie6y states that scirrhus of the'
uterus is to be treated by applications of a digestive and emellieiit nature,
namely, emollient oils and fats, mixed with such things as galbanom,
bdellium, and the like.
Of the Arabians Avicenna is the most minute, but his treatment is borrowed
fjrom the Greeks. Ualy Abbas remarks that Scirrhus has a tendency to ter-
aiinate in dropsy, and it is attended with sallowness, weakness, loss of appetite,
amenorrhisa, swelling oflhe breasts and belly. His remedies are similar to
those for cancer.
See an interesting acceiuil of this disease by Lodovicus Mercatus, ap.
Gyrutcia, p» 951.
LXIXr — ON THE MOLB.
Br the first species of Mole here described, enlargement of the ovaria and
perhaps scirrhus of the neck of the womb are meant. The other species is
BOW well understood, and is described by many ancient authors. — See an
account of it at the end of Aristotelis Uistoria Animedium, also Plinius, H.
N. vii. 15., and x. 64. — Hippocrates, de Steril. xx- — Plutarch, t. i. p. 252,
ed, Xylander. — Nonnus, c. 212. — Rhases, ad Mamor, ix. 88., Cont, xxii. —
Moschion, de Morb, Mulkrum, § 125. Galen and Avicenna agree in re-
presenting the true Mole as a corruption of the male semen, and consequently
they believed that it never occurs in virgins. Hanneman and other modern
authorities maintain the contrary. — See Dissertations on the Mole by Van
Swieten, Comment. § t326., by Ambrose Par^ de Horn. Genit. xxxiii., by
Martinus Akakia, ap, Gynac. p. 773., by Lodovicus Mercatus, ap. Gynac.
p. 1013., by Leonardus Jacchinus, Comment, in BJuisis, lib. ix* c. 71., and by
liuysch, Anat, Chirurg. Cent,
Aetius gives an account of the former species, but it is little different from
our author s. He recommends, in the first place, emollient applications of
all kinds, namely, baths, pessaries, and fumigations, andWflerwards dropaces,
sinapisms, and the like» The same plan of treatment is pursued by Avi-
cenna. Haly Abbas and Alsaharavius describe the two species of mole in
exactly the same terms as our author. Rhases also describes the two species of
mole, namely, the one which is hard and round, and tiie other or soft species
to which the name is now generally restricted.
Hippocrates relates a curious case of a calculus which was discharged from
the uterus of a woman 60 years old, who had long felt pain in that region dum
venere uteretur, Aetius also makes mention of the uterine calculus. Lodo-
vicus Mercatus gives a curious account of this subject, Gynac. p. 969.
Michaelis Angelus Morus relates a singular case of a woman who died of
uterine calculi.— -V. Masgeti Bihl. Chirurg. lib. xviii.
COMMENTARY ON THE THIRD BOOK. 457
LXX. ON INFLATION OF THB WOMB.
This complaint is mentioned by Hippocrates, Epidem. lib. vii., and by
Galen, Meth. Med. xiv. 7., and de Causis Si^tnpt, iii. 2. Our author's ac-
count of it is taken from Aetius. Octavius Horatianus and Nonnus direct
similar applications, only tlie former says nothing of bleeding. Ualy Abbas,
in like manner, omits venesection, but recommends applications consisting
mostly of carminative substances, such as parsley, birtbwort, dill,, rue, and
fennel. They are to be used in the form of baths^ fomentations, and injec-
tions. Alsaharavius recommends bleeding, anointing the womb with oil of
rue, baths prepared with rue, camomile, mace, cumin, &c., cupping-instru-
ments applied to the pubes, and so forth. Avicenna and Rhases refer to
Aetius and Paulus, and treat of the complaint in like manner.
See a full account of this disease by Lodovicus Mercatus, ap. Gynae. p.
944. Mr. John Hunter, in his work on the Animal Economy, mentions in-
flation of the womb as an example of the formation of air in the body with-
out putrefaction. Marcellus Donatus relates an unequivocal case of this
disease. — Hist. Med. Mirah. iv. 25.
LXXI. ON UTRRINB SUFFOCATION, OR THB HY8TBRICAL CONVULSION.
See Hippocrates, de Nat. Muliebri. — Galenus, sec. loc. ix., de Loc. Affect,
vi. 5. — Aretaeus, Morb. Acut. ii. 11. — Celsus, iv. 20.— Moschion, de Morb,
Mul., c. 129. — Eros, ap. Gynacia. — Aetius,, xvi. 78. — Oribasius, Synop. ix.
47. — Acluarius, Meth. Med. iv. 8. — Nonnus, c. 210. — Alexander Aphrodt-
sieus, Probl. ii. 64. — Serapion, tr. v. 27. — Avicenna, lib. iii. fen. 20. tr. iv.
c. 16. — Ualy Abbas, Pract. viii. 12^ Theor, ix. 39. — Alsaharavius, tr. xxv.
§ 2. c. 12. — Rhases, ad Mansor. ix. 87., and Centinens, xxii.
From the days of Hippocrates to those of Actuarius, and long afterwards,
the hysterical convulsion was accounted for in the manner explained by our
author. It accords not well with modern ideas upon the subject; and, pro-
vided it be admitted as a fact, that men are sometimes, though rarely, seized
with hysterical convulsions, there can be no doubt but the ancient hypothe-
sis must at once fall to the ground. Perhaps a stickler for the ancient doc-
trine, while he admitted with Aretams that men are subject to complaints
resembling hysterics, might hold with a late intelligent writer, Mr. Tait, that
men are never affected with the real hysterical convulsion.
According to Hippocrates, this complaint most frequently attacks anti-
quated virgins or young widows. If the womb, he says, ascend to the liver,
the patient suddenly becomes speechless, her teeth are fixed, and her colour
becomes pale. His treatment consists of applying a tight swath round the
middle, giving fragrant wine, applying fetid things to the nose, and fragrant
things to the uterus. The belly is to be purged, and castor and fleawort
given internally. Herodotus, the historian, mentions that, the ancient Scy-
thians used castor for the cure of complaints of the uterus.— Lib. iv.
Galen is at great pains to explain how the uterus is retracted upwards
and to the sides by its ligaments, but his explanation is too long for my li-
mits, and, therefore, I must content myself with referring the curious reader
to it, de Loc. Affect., u. s. He says, in another place, that, when uterine suf-
focation take place, there is loss of sense and of motion, a small feeble pulse,
and sometimes asphyxy He recommends to take agaric and plantain in
wine ; to smell to bitumen, castor, liquid pitch, cedar rosin, &c. ; to fumigate
the parts with hartshorn, and to apply to them rue and honey upon wool.
Celsus thus marks the distinction between the epileptic and hysterical coii-
438 COMMENTARY ON THK THIRD BOOK.
vulsiou : — *^ Interdum eiiam sic exanimat ut tanquam comitiali morbo pros-
teriiat. Distat tamen hie casus, eo quod neque oculi vertuntur, nee spumse
proHuunt, nee nervi distenduntur; sopor tantum est/' If the strength per-
mit, be approves of venesection, or of cupping the groins without scarifica-
tions ; then fetid things are to be applied to the nose, and fragrant things to
the uterus, the whole body is to be rubbed, sinapisms are to be put to the
lower part of the belly, and castor, gith, and dill given internally.
Aretaeus surpasses every other ancient author in his description of this
aflfection. He sets out with pronouncing the uterus to be, as it were, an
animal within an animal, wandering upwards, downwards, and to either side,
being attracted by fragrant things and flying from fetid. When, therefore,
it ascends upwards, it occasions compression of the liver, diaphragm, lungs,
or heart, and sympathetically with the last, also of the carotids. It is ac-
companied with heaviness of the head and loss of sensibility. Nearly allied
to it, but yet a different aflection, is a complaint which attacks men, having
therefore no connexion with the uterus, and not being relieved by fetid
things. He says that, when the attack proves fatal, the pulse sinks and be-
comes irregular and intermittent, there is a strong'sense of suffocation^ loss
of speech, loss of sensibility, respiration unequal or not even perceptible,
sudden and unexpected death. For some time after, the countenance does
not put on the appearance of death, but is redder than natural, and the eyes
project. He also gives a good account of the treatment, which, however,
cannot be said to differ in any material respect from that of Galen and Cel-
sus, as explained above. The same may be said of Oribasius, Nonnus, and
Octavius.
Aetius is very minute in his description. He remarks that, after respira-
tion by the mouth is stopt, the arteries may continue to beat, as is the case
with reptiles in winter. The disease, he says, is occasioned by a flatulent re-
frigeration, and not by inflammation, as Soranus has said.
Actuarius accounts for the complaint and describes it in the same terms
as the preceding writers. As it'oceurs principally with virgins and widows, he
prescribes for them the Hudibrastic mode of wooing widows !!
Eros gives the same account of the symptoms and treatment as the others.
Moschion, however, disapproves entirely of the common practice of apply-
ing fetid things to the nose, ligatures to the extremities, and fragrant pessa-
ries to the uterus. On the contrary,- he recommends warm fomentations,
injections of warm water thrown into the uterus, rubbing the body with
warm hands, and, when the disease gets into the chronic state, giving altera-
tives (metasyncritica) and hellebore.
See in Alexander Aphrodisieus an ingenious explanation why fetid sub-
stances applied to the nose, and fragrant ones to the parts below, were sup-
posed to prove beneficial in such cases. It is too long for my purpose.
The account which Plato gives of the nature of the uterus and the pheno-
mena of hysterics ought perhaps not to be taken in too literal a sense, consi-
dering that philosopher's well-known propensity to mystification. He says,
that part in women which is called the womb, being an animal desirous of
generation, if it become unfruitful for a long time, turns indignant, and,
wandering all over the body, stops the passages of the spirits and the respi-
ration ; and occasions the most extreme anxiety and all sorts of diseases.—
Timaus,
The Arabians describe and treat the complaint exactly like our author.
Serapion says that the uterus is delighted with fragrant things, and flies from
fetid, not because it is an animal but from a natural property. He recom-
mends ligatures to the extremities, purging with biera picra, bleeding if not
contra^indicated, the application of fptid things to the nose, and of fragrant
things to the uterus, and so forth. Avicenna states that the affection arises
COMMENTARY ON THE THIRD BOOK. 459
from the menstiual discharge or semen being retained in the uterus. Ualy
Abbas adopts this explanation. He says the uterus affects the brain and
heart sympathetically, giving rise to apoplexy, epilepsy, and other serious
complaints. Young women, especially widows, are most liable to it. He
says it is often periodical like epilepsy, His treatment consists of ligatures
to the extremities, with friction, sprinkling rose-water on the face, applying
fetid things to the nose, and the other means use^l in cases of suspended ani-
mation. At the same time he directs to apply fragrant things to the parts of
generation, and dry cupping to the Hypogastric region. This is the treat-
ment during a fit. To remove the tendency to the affection, h^ recommends
the warm bath medicated with wormwood, bay leaves, marjoram, &c. fetid
pills, hiera picra, and the like; and, when connected with suppression of the
menstrual discharge, he directs to bleed at the ancle, or even at the arm, if
there is fulness and redness of the face. If the woman is unmarried, he re-
commends a change of life. Alsaharavius states, that there is this difference
between the hysterical and the epileptic convulsion, that in the former the
woman does not lose her senses, nor emits foam at the mouth. Like Haly,
he directs to bleed at the ancle when the menses are obstructed, to apply
cupping-instruments to the thighs and Hypogastric region, and tatake diure-
tics and emmenagogues. There is nothing peculiarly interesting in Rhases,
as his account of the disease is collected from preceding authors. One of
them seems to say that the ascension of the uterus is not real but apparent.
He remarks, that affections of the uterus are attended with pain of the oc-
ciput.
Sanctorius and Ambrose Par^ treat of the hysterical fit exactly as the an-
cients.— See an interesting dissertation on it by Lodovicus Mercatus, ap,
Gynacia. Rogerius and the other writers of that age follow the ancient
views respecting the nature of this affection. Tr. i. c. 63.
LXXIL ON PROLAPSUS UTERI.
This complaint is particularly well treated of by the Father of Medicine. He
has even described the case of a complete procidentia, when, he says, the
uterus hangs down like the scrotum. Similar cases are related by modern
authors. — See Burns' Midwifery, p. 96 and p. 616. Hippocrates directs to
make cold applications to the pudenda ; to wash the part with an astringent
lotion, and restore it to its place. He afterwards gives directions to make
the woman lie upon her back with her legs crossed and tied together; and,
if the disease be likely to return, he recommends cupping and pitching of the
hypogastrium.
Celsus mentions Prolapsus, and recommends for it hip-baths of salt or as-
tringent water, and local applications of a styptic nature after the womb has
been replaced.
Areteeus, with his usual talent for description, draws a melancholy picture
of a woman labouring under a complete procidentia uteri. He says it is
occasioned by abortions, violent concussion, or severe labour; and explains
very well how this happens from relaxation or rupture of the ligaments of the
uterus.
Our author takes his account almost word for word from Aetius, who ac-
knowledges his obligations to Soranus.
Alsaharavius recommends nearly the same plan of treatment as Hippo-
crates; and directs, when the attempts at reduction fail, to extirpate the womb
by an operation. Avenzoar relates a case in which he saw the whole uterus
projecting externally. He did not know the issue, only he was sure that the
disease subsisted for a considerable time. He also relates another case upon
460 COMMENTARY ON THE THIRD BOOK.
the authority of a friend of undoubted veracity. Haly Abbas likewise men-
tions that the uterus sometimes protrudes fairly out, and enumerates the
same causes of the complaint as our author. He relates that cases have
occurred of tlie whole uterus having become putrid and been removed entire.
RhaseSy Avicenna, and Serapion, appear to have derived all their information
from Aetius and Paulus. Rhases directs to bathe the parts with styptic de-
coctions, to put the woman into a bath medicated with roses, myrrh, &c., to
reduce the womb, and retain it with compresses soaked in an astringent so-
lution.
Eros recommends baths composed of the decoctions of acorns, pomegra-
nate rind, sumach, galls, &c. ; also astringent fomentations, and a cooling
diet.
The ancients appear not to have used pessaries made of solid materials,
such as wood and metals. See plates of Circular and Globular Pessaries in
Heister, Chirurg. p. ii. § 5, c. 157.
LXXIII. ON PHIMUS, OR OBSTRUCTION OF THB 08 UTBRI.
Imperforate Hymen and other obstructions of the Vagina requiring a
surgical operation will be treated of in the Sixth Book. The case here
treated of is simply an obstruction of the os uteri by a callous substance.
The emollient treatment by pessaries here recommended appears very pro-
per. Aetius makes mention of a more efficacious but dangerous application,
namely, a piece of sponge spread with an ointment containing arsenic, alum,
&c. Hippocrates had recommended an application containing verdigris. —
De Steril. xii.
Avicenna treats the complaint solely by a surgical operation. Alsahara-
vius approves of the emollient treatment, such as decoctions of mallows,
fenugreek, linseed, &c.
This disease is of rare occurrence, but has been described by Astruc,
Hartman, and other modem authors. See a paper by Dr. A. T. Thomson
in the Med, Chir» Trans, vol. xiii. p. 1 .
LXXIV. ON STBRILITT.
Hippocrates in his ingenious work on Sterility assigns the following
causes for a woman's not conceiving : — First, because the os uteri is turned
obliquely from the passage to it. (In the Kalligononiia, a singular work
published a few years ago, replete with curious information and gross ob-
scenity, this is stated to be a common cause of sterility.) Second, because,
the inside of the uterus being too smooth, either naturally or in consequence
of the cicatrices of ulcers, it will not retain the semen. Third, when, owing
to suppression of the menses, any obstruction takes place about the os uteri,
it is apt to prevent impregnation. Fourth, when menstruation does not take
place, the veins of the uterus become so gorged with blood that they do not
retain the semen ; or, on the contrary, the same effect may arise from profuse
menstruation whereby the retentive faculty of the vessels is weakened ; or a
return of the menstrual fluid in too great quantity may wash away the semen.
Fifth, prolapsus uteri, by rendering the mouth of the womb hard and callous,
prevents impregnation. The treatment is delivered at so great length that I
cannot venture even to give an abridgment of it.
Aetius treats very fully of sterility, but his views are pretty much the same
as our author's. See also Oribasius, Si/nop. ix. 45.
In cases of sterility, Octavius Horatianus directs to ascertain whether the
COMMBNTARY ON THE THIBD BOOK. 461
OS Uteri be turned aside or shut up. He delivers the treatmeut of these cases
with singular minuteness. His principal remedies are pessaries, which, of
course, are composed of various ingredients. We shall give the composi-
tion of one of the simplest of them in his own words : — ** NuUo etenim re-
medio meliore et magis innoxio, aut corrigi matrix poterit, aut purgari, quam
usus nitri suppositione.'' That is to say, a suppository of soda is one of the
safest and most effectual remedies.
Serapion, like Aetius and Paulus, regulates his treatment entirely upon
the principle of correcting the intemperaments, which he considers as the
most common causes of sterility. A humid intern perament, he says, occa-
sions sterility in the same manner that wet ground proves injurious to seed
which is sown upon it; and a hot intemperament dries up the semen as the
earth scorches the seed during the heat of the dog-days. Such being his
ideas of the causes of sterility, one can readily comprehend his principles of
treatment. Avicenna, Rhases, and Avenzoar likewise direct their attention
to the correction oi the intemperaments, but also recommend to pay atten-
tion to any other local complaint about the genital organs. Ilaly Abbas,
among other remedies, directs to correct the state of the uterus by means of
stimulant fumigations. One of his prescriptions contains arsenic. This
would prove a potent but dangerous application. Alsaharavius expresses
his distrust in the virtues of many specincs which had long retained cele-
brity for the cure of sterility. Like the others, he directs to find out the cause
of it, and remove it if possible by suitable remedies.
Plutarch thus enumerates the causes which had been supposed to explain
why a woman does not conceive after every act of coition. Diodes the
physician maintained, that it is either because no semen has been emitted,
or less than necessary ; or because it does not contain the prolific principle ;
or from the deficiency of heat, coldness, moisture, or dryness ; or from re-
laxation of the uterus. The Stoics held that it is from the obliquity of the
penis, so that it does not project the semen straight forward ; or from dis-
proportion between the genital members. Erasistratus taught that it is occa-
sioned by callosities and fleshy excrescences; or from the uterus being more
spongy or smaller than natural. — De Flacit, Fhilos. v. 9.
LXXV. ON FISSURES, CONDYLOMATA, AND HEMORBHOIDB«
This chapter is mostly compiled from Aetius, xvi. 97. and 107. The as-
tringent applications, recommended by Aetius contain alum, pomegranate
rind, ceruse, litharge, burnt lead, hypocistis, &c. For Condylomata, the
Pseudo-Dioscorides recommends an application containing arsenic. — Eupo-
rist.ii, 218.
Avicenna and Rhases give a similar account of these complaints. They
direct to apply to hemorrhoids either such astringents as those directed
above, or to remove them by a ligature. Haly forbids to use caustic medi-
cines, as they may prove injurious to the uterus ; and prefers extirpating them
by a surgical operation. For Fissures he directs to use basilicon, with the
fat of a duck or hen, and oil of violets, along with pitching and cataplasms.
Alsahai*avius directs to extirpate hemorrhoids by an operation; and, when
the basilicon ointment does not succeed with the condylomata, to treat them
similarly. As the ancients have not described polypus uteri by name, I
am inclined to think that they must have comprehended it and all the other
tumours about the uterus under the general appellation of hemorrhoids.
462 COMMENTARY ON THE THIRD BOOK.
LXXVI. ON DIFFICULT LABOUR.
Hippocrates has treated fiilly of Difficult Parturition in the First Book
of his Treatise de Morbis Mulierum, from which we shall select a few re-
marks to give the reader some idea of his practice in these cases. When
the child presents doubled at the mouth of the womb, he directs to push it
upwards, and rectify the position so that the head may come down. When
a band or foot of a living child protrudes, it is to be pushed up in like roan-
oer, and the head made to present. When the leg or arm of a dead child
protrudes, it is best, he says, to proceed in the same manner if possible;
but otherwise they are to be amputated at a joint and the head opened.
The process of opening the head is minutely described by him. lie advises
likewise to open the chest when any difficulty of delivering it is experienced.
When in feet presentations the head is retained after the body is delivered,
he advises to introduce a hand between the os uteri and the head and de-
liver it. When the secundines are retained, he orders to extract them slowly,
and for this purpose directs that, the woman being placed on a stool, the
child not having been separated is to be allowed to hang down, so that by
its weight it may produce separation ; and, lest its weight should occasion
too strong pulling, he advises to lay it on wool or bladders filled with water,
which being perforated, the child will sink down gradually and draw away
the placenta. We will have occasion to treat of this practice further in the
Sixth Book.
Celsus directs, when the child is dead, to introduce the hand, finger by
finger, into the womb, and examine the presentation, which will be the head,
the feet, or the body laid transverse. He states that the object of the ope-
rator is to bring down the body either by the head or the feet. When the
arm presents, he directs to bring down the head, which is to be seized by
means of a hook fixed in the eye, ear, mouth, or forehead, and cautiously
pulled along ; and in doing this he properly directs to pull with one hand
and keep the other fixed at the instrument. When the feet present, they are
to be brought down and delivery accomplished in this way. When the
child lies across, he recommends, if the position cannot be got rectified, to
fix the hook in one of the arm-pits and pull it down; but, if other means
fail, he directs to divide the body at the neck and extract the parts sepa-
rately. In extracting the secundines, he properly directs to stretch the cord
gently with the lef^ hand, and, introducing the right into the uterus, to sepa-
rate the placenta from the womb and remove it along with the coagiila of
blood lying there.
The causes of ditficult paiturition and the methods of remedying them are
more fully treated of by Aetius than by any other ancient writer; but, as
Paulus evidently copies from him, we shall merely supply a few things which
our author has omitted. Among the causes of difficult labour, he mentions
too compact a union of the ossa pubis. When the woman is too young or
too old, he justly remarks that she wants strength to accomplish delivery
readily. He mentions that in the delivery of twins the two children may
get entangled. He means, I suppose, that the head of the one may follow
the delivery of the breech of the other. Of this singular complication, a fatal
case was published in the Edinburgh Medical and Surgical Journal a few
years ago. He expresses himself favourably with respect to feet presenta-
tions. All cross presentations are said to be difficult to rectify, but the
child is to be brought by the head or the feet according to circumstances.
When delivery is retarded by rigidity of the parts, he strongly recommends
the warm bath. When fulness of the bladder occasions obstruction, he pro-
perly directs to draw off the urine by a catheter. When a foot or hand
COMMENTARY ON THK THIRD BOOK. 463
presents, he directs not to pull down the part, lest it become more firmlj
impacted, or lest it should be fractured or dislocated ; but the projecting part
is to be pushed up and the position restored. Smellie, by the way, has
shamefully misrepresented the practice of Aetius. — Midwifery, vol. i. Intr.
p. 16.
According to Kros, one of the most common causes of difficult parturition
is heat and tumefaction of the CYtemal parts. In this and in other cases,
he directs to sit in a bath prepared with emollient herbs, and to nib the parts
about the belly with oil of violets or of roses.
Serapion treats this subject in nearly the same terms as our author. Like
the Greeks, he approves of emollient oils and baths to produce relaxation.
The same practice is commended likewise by lihases. When the membranes
are tough, he advises to tear them with the fingers, or to open them with a
knife.
Avicenna has treated of difficult parturition with his usual accuracy, which
exhausts every subject which he handles. He states that the expulsion of
the child is performed by the abdominal muscles. This was the opinion of
Galen ; and 1 am inclined, upon the whole, to think it pretty correct. He
approves greatly of the bath, both before labour has come on and during the
time of it. When delivery is difficult, owing to the size of the child, he di-
rects to apply a fillet round the child's head and endeavour to extract it.
When this does not succeed, the ^brri^e* are to be applied, and the child ex-
tracted by them. If this cannot be accomplished, the child is to be extracted
by incision, as in the case of a dead fcetus. This passage puts it beyond a
doubt that the Arabians were acquainted with the method of extracting the
child alive by ihe forceps,
Albucasis recommends, when the membranes are tough, to perforate them
by the finger or a spatumile. When the waters are discharged, he directs to
press down the woman's belly so as to make the head descend. If it does not
come down readily, he advises to give a clyster, and afterwards to apply com-
pression to the beily. I have been told that Dr. Clarke of London adopted
this mode of practice with singular success, and I myself can speak of its
efficacy from ample experience. Albucasis alsoapproves of the tepid bath.
To promote the delivery of the secundines, he recommends to make the
woman sneeze and retain her breath.
Alsaharavius (probably the same as Albucasis) treats fully of the causes
of difficult labours. When occasioned by dryness and constriction of the
vagina, he recommends baths, fomentations, and clysters, containing the de-
coctions of mallows, fenugreek, and linseed ; and also directs to rub the parts
with warm oil. When obstruction of the rectum by fsces prevents delivery,
he advises to administer a clyster. When intense cold is the cause of the
difficulty, he recommends clysters of hot oil and the warm bath. When the
membranes are tough and retard delivery, he directs the midwife to break
them with a sort of reed or needle.
Haly Abbas mentions imperforate hymen among the causes of difficult
labour. Such cases have been reported by modej'n writers on midwifery.
See Boudelocque, § 341., and Burns' Midwifery, chap. x. Fabrice d'Aqua-
pendente relates a very curious case in which conception had taken place
without rupture of the hymen. — (Fmvres Chirurg, p. ii. c. 81. When the
difficulty arises from fatness and debility of the expulsive powers, Ualy di-
rects to rub the parts with warm olive oil, or other such emollients, and to
make the woman sit in a bath prepared with camomile, meiilot, &c. He
mentions as an internal remedy the infusion of a swallow's nest (alcyonium?).
When the difficulty proceeds from cold, he recommends the use of the tepid
bath ; and, when from the contrary cause, he advises to apply coolinsr things.
According to Rhases, difficult parturition may arise from the mother^ the
464 COMMENTARY ON THE THIRD BOOK.
fcetus, or the secundines. He appears to have considered all presentations
unnatural except the head. In the other cases, he says, the life of the mother
or child is endangered, although, he adds, -many living children are born by
the feet. When delivery of the head is found difficult, he recommends to use
ligatures or fillets. When the feet or hands present, he directs to restore the
position, or, if that is impossible, to bring down the feet. Many of his autho-
rities mention the warm bath and lubricants.
Ambrose Par^ mentions cold as a cause of difficult labour, and recom-
mends the tepid bath. — De. Horn. General, Rogerius and most of the
•earlier medical authors also recommend the batli to promote labour. It is
singular that this practice should now be abaudoned. From the sketch
¥rhich we have given above, it will be seen that the Arabians have made men-
tion of the forceps ; but that, most probably, the Greeks were unacquainted
with this instrument. This was no vei7 great defect in their obstetrical prac-
tice, if the estimate which the celebrated Dr. Hunter made of the good and
bad effects which have resulted from the modem use of it be correct. " 1
am clearly of opinion,'' says he, in one of his latest publications, " from all
the information which I have been able to procure, that the forceps, upon the
whole, has done more harm than good.'' In more cases than is generally be-
lieved very serious injury is done both to the mother and the child by the
application of the forceps.
Before concluding this subject, I cannot help remarking, that Professor
Sprengel and Mr. Moir, in their Histories of Medicine, have represented the
ancient practice of midwifery as being much more rude and defective than
it was in reality^
LXXVII. ON ISCHIATIC DISEASE.
Consult most of the authors referred to in the next chapter.
Hippocrates gives a pretty correct account of the symptoms which attend
an attack of Morbus Coxarius, or Ischiatic Disease. He says it most com-
monly arises owing to the fluids of the joint being dried up by exposure
to the sun. It is accompanied, he justly remarks, with pain of the loins and
vertebrae of the back, shooting down even to the knees. A sharp hot pain,
he adds, is frequently seated in the groins. Upon any motion the most
piercing cries are extprted.— Dc Diebus Jtidicariisy c. 6.
In Ischiatic Disease Galen recommends general bleeding, and, most es-
pecially, emetics, which, he says, by occasioning a determination upwards,
operate more beneficially than purgatives in this complaint. He disapproves
of acrid embrocations, but approves of cupping. He also allows stimulant
clysters of colocynth. He gives a long list of local applications from An-
dromachus, Asclepiades, and Democritus. He makes mention of the Iberian
herb; for further information respecting which I refer the reader to Matthio-
lus, op. Dioscvrid, lib. i. 147., and Bernard, ap, N&nni Epit. c. 215. He
recommends, in certain cases, to beat the part with rods^— JMcM. Med.
xiv. 16. See also Pseudo-Dioscorides, Euporist, i. 240.
Celsus says that Morbus Goxarius is a painful xiomplaint, and difficult to
cure. He recommends warm cataplasms and fomentations, with various
applications of an emollient or stimulant nature. If inflammation come on,
cupping-instruments with scarifications are to be applied ; diuretics are to be
given ; and the belly is to be opened, if constipated. He also approves (^
friction, and even of forming issues by burning with a red-hot iron.
Various methods of performing the operation of burning are detailed by
Aetius.
Cselius Aurelianus gives a long and interesting account of this complaint.
COMMKNTARY ON THE THIRD BOOK. 4G5
Among the symptoms he mentions the lengthening and shortening of the
limb, the wasting and paralysis of it. The periosteum, he says, is princi-
pally aflfected, but likewise the heads of the muscles* He correctly states,
that, when the complaint is protracted, collections are apt to form in the
joint. He approves of the emollient treatment, the application of wool dip-
ped in sweet oil, fomentations, and bleeding from the arm. He recommends
gentle purgatives and clysters, but condemns the use of drastic cathartics,
such as scammony, hellebore, and the like; because, he says, they occasion
irritation. When the pains are protracted he approves of scarifications and
leeching, after which the vapour ot sponges squeezed out of hot water will
be of service. He also makes mention of the bath of oil and various
emollient ointments. He describes several methods of applying heat to the
part, but condemns them in general upon the principle that they increase the
local irritation. He disapproves of diuretics as recommended by Diodes,
and otherwise animadverts freely upon the practice of the other sects.
The Arabians adopt the views of Galen and his followers with little addi-
tion or alteration. Thus Serapion recommends bleeding from the arm and
ancle; clysters of drastic medicines, such as colocynth, centaury, hermo-
dactylus, &c. ; soothing applications externally ; quieting medicines inter-
nally ; emetics consisting of radishes, vinegar of squills, or even of white
hellebore. When these do not succeed, he recommends to form an issue by
burning the part with a red-hot iron. Avicenna agrees with Galen in con-
demning discutients and recommending emollients at the commencement,
and in preferring emetics to cathartics. For this purpose he particularly
mentions a solution of nitre and vinegar. When the disease is combined
with inflammation, Haly Abbas directs to begin with venesection if not
otherwise contra-indicated. He enjoins the necessity of abstaining from
taking much food and things of difficult digestion. He directs to pour
water of a moderate temperature over the part, and to rub it with an emol-
lient oil ; but he forbids to use refrigerant and astringent things, as they are
apt to drive the humour inwards. He joins the others in recommending par-
ticularly the hermodactylus (soureniuron) both by the mouth and in clysters.
When other means fail to remove the pain, he directs to apply a cupping-in-
strument with strong heat over the joint, or even to use the Actual Cautery.
Alsaharavius recommends the same general plan of treatment. He directs
to abstaia from the use of wine, or, if the patient cannot observe this regimen,
he recommends to use the bath and friction with glass (pounded he proba-
bly means). He gives very excellent admonitions to guard a$rainst indiges-
tion, and to avoid all things of a cold nature.
On the ancient cauteries for disease of the hip-joint see Book Sixth, c. 72.
Most of the earlier modern writers approve of the application of the Ac-
tual Cautery for the cure of schiatica. — See Rogerius, tr. i. c.74.
LXXVIII. ON GOUT AND RHEUMATISM.
Consult Hippocrates, Aphor. lib. vi., Prognost. c. 15. — Galenus, Com-
tnent. in Aphor, Hippocr., de Med. sec loc. lib. ix. — Celsus, iv. 24. —
Serenus Samonicus. — Aretaeus, Morb. Chron. ii. 12. — Scribonius Largus,
c. 41. — Cielius Aurelianus, Tard. P. v. 2. — ^Alexander, lib. xi. — Aetius, lib.
xii.— Oribasius, Si/nop. ix. 58i. — Actuarius, Meth. Med. i. 21.— Nonnus, c.
216. — Marcellus, de Med. c. 35. — Octavius Horatianus, ii. 21. — Demetrius
Pepagomenos, de Podagra. — Psellus, Opus Medicum. — Macrobius, Satur-
nalia, vii. 4. — Lucianus, Tragodopodugra. — Serapion, tr. iv. 25. — Avenzoar,
lib. ii. tr. 3, c. 28., lib. ii. tr. 7, c. 31. — Avicenna, lib. iii. fen. 22, tr. 2. —
Haly Abbas, Theor. ix. 41., Pract. viii. 32. — Alsaharavius, Pract. tr. 38. —
H h
466 COMMENTART ON TRB THIRD BOOK.
Rhases, Divis, 102., ad Mansor, ix. 90., Libellus cb Morb. Junct., and Con-
tincns, lib. xxvi.
The prognostics of Hippocrates will be admitted at the present day to be
correct. Those who are old, or have chalk-stones formed in their joints, or
lead a laborious course of life, or have dried bellies, cannot be cured by any
human means. Young persons, not having tofi formed in their joints, and
who live guardedly, and whose bowels will bear the proper treatment, may
be cured. These complaints are best removed by dysenteries or other eva-
cuations downwards. His principal remedies are purgatives administered
by the mouth or by injection, and local applications of a cooling nature, and
even pouring cold water on the foot. When the pain of the gout becomes
fixed m a joint, he directs to burn it with crude flax. — Our Sydenham and Sir
William Temple mention burning with moxa rather favourably; and the
practice is still pretty common in France.
Seneca mentions it as a monstrous example of the depravity of his age,
that the women, by their luxurious habits, had become subject to gout. —
Epist, 95.
According to Galen, gout and arthritic complaints are occasioned by a col-
lection of some humour in the affected part. This humour may be blood,
phlegm, or a mixture of phlegm and bile, or of blood along with these, or
simply a crudity. This crude humour, he remarks, sometimes concretes into
tqfi. The first indication in attempting the cure is to evacuate the offending
humour by bleeding or purging ; and then repellent and discutient applica-
tions are to be used. He has given a great many prescriptions for these.
For an able and full explication of the ancient theory of the humours, and
the manner in which they give rise to athritic complaints, I refer the reader
to Macrobius. Notwithstanding its being at present in little repute, I am not
afraid to declare that, in my opinion, it accords better with the phenomena of
the disease, and is a more successful guide to practice, than any hypothesis
which has been recently advanced. Even Sprengel prefers it to the theory of
Dr. Cullen.
Unfortunately the chapter of Aretaeus on the treatment of arthritic com-
plaints has come down to us in a mutilated state. It appears, however, that
he trusted to hellebore as the great remedy in such* cases. His local ap-
plications are wool dipped in rose-oil and wine ; a sponge soaked in oxy-
crate, or such like cataplasms. When the disease is hereditary, he says it is
generally incurable.
Celsus recommends various refrigerant and anodyne applications to the
affected part, such as a sponge soaked in cold water, or in oil and vinegar.
Of the same soaked in hot water having poppies boiled in it, or a mixture of
pitch, wax, and alum. The other points of his practice deserve attention,
but I shall not enter upon them, as I wish to afford room for a fuller abstract
of the doctrines of Alexander.
Gout, according to Psellus, is occasioned by an atony of the nutritive
faculty, whereby a thick humour is collected in the system.
Alexander begins with noticing the common opinion that gout is irreme-
diable by the art, which he affirms not to be the case provided proper atten-
tion be paid to the different varieties of it. There are, he says, many causes
of the disease; for sometimes a hot blood flows into the cavity of the joint
and occasions violent pains ; and, in like manner, a defluxion of bile get-
ting between the tendons and ligaments occasions ' pain by burning and
stretching the parts. Phlegm likewise, by producing cold and compression,
becomes the cause of violent pains. In like manner the melancholic humour,
not only by its coldness and pressure but by occasioning a sense of heavi-
ness, brings on no ordinary paroxysms. Sometimes a simple quality of
the humours, such as heat, cold, dryness, or humidity, will cause a defluxion.
COMMENTARY ON THB THIRD BOOK. 467
The prevalence of a bilious humour is ascertained by the absence of swel-
ling; from the pain being rather a fiery heat than distension; and from the
colour being red. The proper remedies in this case are cholagogues, which
must not be of a heating nature, nor offensive to the stomach ; for when the
stomach is deranged the nerves sympathise and rheumatism is the conse-
quence. He gives prescriptions for a variety of such compositions containing
scammony, agaric, and the like, mixed with pepper, &c. He particularly
commends pills of scammony and wormwood. He also directs to use cool-
ing and anodyne applications to the affected parts, such as rose-oil with the
yolk of an egg, and the like. He enjoins particular attention to the diet, in
order to avoid such things as have a tendency to form bile. He recommends
moderate exercise rather before than after a meal, but forbids to carry it to
excess. He speaks favourably of baths of common water, which practice,
by the way, was much approved of by Sir John Floyer. He concludes this
part with minute directions about the local applications; but, as we have al-
ready stated his principles, we shall not enter upon the detail of his practice.
When gout is occasioned by phlegm, the part is neither hot nor red ; is bene-
fited by calefacients and injured by refrigerants. For this variety he recom-
mends particularly a combination of purgative and attenuant medicines, such
as the Julian oxymel, which contained white hellebore, agaric, polypody,
thyme, cumin, &c. After purging he greatly commends hot and attenuant
medicines, in particular the composition from coral, which, among other in-
gredients, contained birthwort, spikenard, cloves, myrrh, &c. (Birth wort
formed one of the principal ingredients of the celebrated Portland powder.)
He describes various other antidotes containing bitters, atlenuants, and cale-
facients. His local applications in this case are pounded cabbage, parsley
seed, or flea-bane, if the pain is moderate; but otherwise he recommends
anodyne cataplasms. Should these, however, rather produce an increase of
the pain, he directs to substitute instead of them discutient and repellent
applications, such as decoctions of thyme, mint, &c. with vinegar. He also
recommends various cerates with the same intention. Some, he says, have
been benefited by stronger applications, such as blisters of cantharides, sina-
pisms, or the like ; but he does not approve of the barbarous practice of
burning with the substances called Iscie(see Aetius and Paulus), nor of the
above-mentioned rubefacients, but prefers a combination of emollients with
discutients. When it is suspected that the gout proceeds from an overflow
of blood upon the joint, he recommends to have recourse to blood-letting,
unless otherwise contra-indicated. He forbids to use such articles of food
as engender much blood, as all sorts of flesh, especially pork; also sweet
wines and intemperance of every kind. He says he has known some cured by
simply refraining from wine. lie then gives directions for the formation of se-
veral topical applications which are of a repellent and discutient nature. He
speaks very favourably of a sponge soaked in an astringent wine oroxycrate.
(Modern prejudices are generally against such local applications, but proba-
bly there is no foundation for them — See Dr. Mason Good's Studj/ of Medi-
cine and Heberden's Commentaries.) He then gives ample directions for
discussing Tofi or chalk-stones. He lays it down as a general rule that such
applications should contain ingredients of a moderately calefacient, discu-
tient, and solvent nature. Among the articles which enter into these compo-
sitions I remark litharge, old oil, sanguis draconis, nitre, turpentine, ammo-
niac, &c. He then states that, as some do not choose to submit patiently to
the methodical plan of treatment, but insist upon getting medicines to allay at
once the violence of the pains, he, although he did not in general approve of
this practice, would now give an account of such remedies. For this pur-
pose, he says, hermodactytus is particularly trusted to by some ; and he ad-
mits that it seldom fails to remove a paroxysm, but aflirms that it occasions
Hh2
468 COMMENTARY ON THE THIRD BOOK.
more frequent returns of it. Some, he adds, have endeavoured to correct its
prejudicial effects by adding to it cumin, mastich, or ginger, thinking that its
action is narcotic ; but this he affirms to be a mistake, for in that case it could
not prove cathartic. He admits, however, that these things may prove useful
by correcting its bad effects upon the stomach. He then gives various re-
ceipts for mixtures containing hermodactylus. As a specimen of them, I
may mention the first, which consists of hermodactylus, myrrh, pepper, and
anise, to which scammony may be added. He recommends, however, in
general, to give it in the form of pills with aloes, scammony, elaterium,
and colocynth. But, as mentioned by our author, instead of it he pre-
fers the coronopodium.— It is the same, I presume, as the coronopus of
Dioscorides, or our buckthorn plantain (plantago coronopus, L.), although
the Commentators are not agreed upon this point. (See Matthiolus.) He
then gives directions for various local applications of an anodyne nature, con-
taining opium, strychnos, ceruse, wax, &c. I regret to say that so admirable a
treatise should conclude with some frivolous directions for curing the disease
by means of amulets of approved efficacy! However, the advocates of the
Mesmerian system of Animal Magnetism do not hesitate to admit their re-
medial powers. (On the Periapta or Amulets of the ancients see Andreas
Laurentius, de Murub. Struma Sanat, p. 85.)
My limits will not permit me to do justice to the account of the gout given
by Aetius. Like Aretsus he maintains that the disease is hereditary. His
general views of the nature of the complaint and his treatment are very
plausible. He says it is occasioned by weakness of the part and a redund-
ance of humours ; that the treatment therefore consists in evacuating the hu-
mours by bleeding and purging, and afterwards in strengthening the part.
Cselius Aurelianus considers arthritis, podagra, and chiragra, as diseases of
the same genus. The usual precursory causes are, intemperance, indigestion,
debauchery, cold, too much or too little exercise, and external injuries. Some,
he adds, are of opinion that it is transmitted from father to son. He gives
the symptoms of these complaints with his wonted accuracy. They are
seated for the most part, he says, in the nerves, by which term he probably
means the tendons and membranes. He remarks the well-known propensity
which persons attacked with gout have to attribute the swelling and pain to
a sprain or some such accident. If the belly be constipated, he advises to
open it by a simple clyster. He recommends to abstract blood from the
affected part by scarifications, which, he says, will occasion less iiTitation
than cupping or leeching. Sponges squeezed out of hot water, or oil and
water, or the decoction of fenugreek, are then to be applied to the part ; for
he thinks these preferable to a cataplasm, as it is often too heavy. When on
the decline, he approves of bathing, spare diet, emollient ointments, and
gentle exercise, beginning with gestation, and proceeding to the stronger
kinds of it. When they can be borne, he approves of stimulant applications,
such as dropaces, heated sand, and even sinapisms. He also speaks favour-
ably of vomiting produced by radishes or hellebore, hip-baths of oil, fomen-
tations with hot salt water, and swimming in hot water or even in cold. He par-
ticularly commends the naturally-medicated waters, or medicinal springs (as
they are now called), such as those of Albula or Cutilia, which, he says, will
either cure or mitigate the complaint. He disapproves of burning the joints (the
reader will have remarked his general aversion to the Cautery) and the in-
discriminate application of various narcotics and other such things. He also
condemns the free use of emetics (which, he says, prove injurious to the
stomach, and occasion a determination to the head), of purgatives, acrid clys-
ters, and diuretics. In short, his practice is not unlike that of our Sydenham.
His grand rule is to keep upon a spare diet, or even to maintain complete
abstinence at the commencement. The formula for his Diacentaureo (as Van
COMMENTARY ON THB THIRD fiOOK. 469
Swieten remarks) is the same as that for the Portland powder, namely, ^
Aristoloch. rotunds; gentians; sum. chamaedryos; centaur, min. p. xquales.
Calius Aurelianus, Galen, Aetius, Celsus, Aretxus, Oribasius, Scribonius, and
lioratianus, make no mention of the hermodactylus. Myrepsus and Actuarius
make mention of a hermodactylus, but Matthiolus and the commentator on
the former think theirs a different plant from the hermodactylus of the other
Greek authors. This may be true, and yet the microscopic eye of critics
often fancies it can see differences which other people are puzzled to remark.
There is nothing very important in Nonnus, Octavius lioratianus, or Ori-
basius. — I will now give a brief abstract of the curious treatise on the gout
by Demetrius Pepagomenos. The work is dedicated to the Emperor Mi-
chael Paleologus, who flourislied about the year 1260 ; and it was published
by Morel at Paris, A. D. 1558. The author commences with explaining the
nature of that derangement of the animal economy which occasions this com-
plaint. This he does at considerable length, but in much the same terms as
Macrobius, to whom the reader has been already referred for an exposition
of the humoral pathology. His physiological opinions appear to me to be
highly ingenious and philosophical. He comes to the conclusion that gout
is occasioned by a collection of humours in the affected joint, these humours
being the product of imperfect digestion and of the retention of excrementitious
superfluities, which ought to have been evacuated from the system. He
says the procatarctic or remote causes of arthritic affections are, long-conti-
nued indigestion, repletion with food, drinking too much wine, venery, un-
usual exercise, indolence, and retention of the natural secretions. Venery,
in particular, is said to weaken the tone of the nervous parts. He then pro-
ceeds to explain that, when crudities are formed in the system, those parts
which are strong and vigorous cast them off, which those that are weak can-
not get accomplished ; and hence collections of such humours take place
in them. The prophylaxis of the complaint, he remarks, is easily laid down,
but is difficult to follow, namely, to observe great moderation in eating and
drinking, and to avoid indigestion. His grand principle of practice is eva-
cuation, which, according to the general rule laid down by Hippocrates, is
the proper remedy for repletion. He then shows that vomiting is the mode
of evacuation most applicable in this complaint, because it empties the sto-
mach, which is the fountain whence the humours are derived. His compa-
rison of the stomach to a fountain which irrigates all parts of the system is
very appropriate, and is beautifully illustrated by him. He recommends,
however, to produce vomiting by simple means; and for this purpose directs
to swallow meat imperfectly chewed, radishes, leeks, &c. and, having drunk
some honied-water, to excite vomiting hy tickling the throat with a feather or
the finger. He forbids the use of strong emetics. His second method of
evacuation is by purging, which he recommends to be done by pills contain-
ing aloes, hermodactylus, cinnamon, and scammony. He then proceeds to
the cure when an attack has come on. In this case, he recommends to begin
with letting blood, unless the stomach be loaded with impurities, when an
emetic must be premised, lest the emptiness of the veins produced by ve-
nesection should cause these crude humours to be conveyed over the body.
Venesection, he remarks, is particularly applicable at the commencement,
when there is simply a plethora of blood, but it is rather prejudicial after-
wards when the fluids become altered in quality. In such cases, as he fully
explains, purging is the proper remedy, especially when performed by her-
modactylus, which, he says, he had found from experience to answer well,
from whatever cause the disease had originated. He directs to combine it
with various cale^cients and aromatics, such as birthwort, cinnamon, and
pellitory. He then makes an ingenious reply to those who affirmed that the
disease is not to be cured by purgatives, but that it is sometimes exacerbated
470 COMMENTAKY ON TUB THIBD BOOK.
by them. In such cases, he properly remarks, it is not the remedy that is in
fault but the misapplication of it. Those who cannot bear cathartics by the
mouth may have clysters given them ; or the preparations from elaterium,
juice of sow-bread, or the like, may be applied to the navel. He afterwards
gives directions about the local applications, which are nearly the same as
those recommended by Alexander. We will have occasion, in the Seventh
Book, to discuss the question respecting the nature of the ancient hermo-
dactylus; and I shall merely state here my own decided persuasion that it
was a species of colchicnm or meadow saffron. It forms one of the ingre-
dients of the celebrated " Eau Medicinale (THusnonJ* From the effects
produced by the " Eau Medicinale*' I am inclined to think, however, that a
certain proportion of hellebore must have entered into its composition, as I
have never found thecolchicum to act so violently as the Blau is said to do. We
have stated above that Cxlius Aurelianus makes no mention of the hermo-
dactylus. However the great modern advocate for methodism. Prosper
Alpinus, speaks favourably of it, and says decidedly that it is the colchicum
of the Greeks. It appears not to have fallen into disuse in his time. — De
Med. Mclh. ix. 4.— The celebrated Sir Henry Halford, who is a warm advo-
cate for colchicum in gout, maintains its identity with the hermodactylus of
the ancients.
The Arabians follow the Greeks closely in the general principles of treat-
ment, only substituting certain articles introduced into the Materia Medica
by themselves. Thus Serapion strongly recommends purging with myroba-
lans, prunes, and tamarinds. He, Avicenna, and Rhases, join in praising the
virtues of the hermodactylus. Their local applications are similar to those
of the Greeks. When the pain is violent, Serapion even approves of pouring
cold water upon the affected part. Rhases approves of burning the joint in
certain cases. Avicenna directs to cover the part with oil and salt, and thus
to apply the cautery gradually. According to Haly Abbas, arthritic diseases
are collections of the superfluities of the system in some joint which is labour-
ing under debility. These superfluities are said to be produced by repletion
and indigestion. The debility is generally occasioned by immoderate exercise,
intemperance, debauchery, or some such cause ; and, a joint having become
weakened, all the impurities of the system are collected into it. He says that
young persons and women who menstruate regularly are scarcely liable to the
gout. lie agrees with the authorities already mentioned in holding it to be he-
reditary. When the humour in thejoints concretes into chalk-stones, he pro-
nounces the case to be incurable. When the disease is produced by a sanguine-
ous plethora, he recommejids to begin with bleeding, and then to use cooling
lotions, or even to pour cold water on the joint. When these do not succeed,
anodyne applications containing opium, mandragora, lettuce, saffron, and the
like, are to be used. When the pain has abated, any swelling which remains
may be discussed by applying to the part a decoction of marjoram, melilot,
camomile, and the like. When the deflnxion is connected with bile, he re-
commends first emetics, and then drastic purgatives, such as aloes, scam-
mony, colocynth, and hermodactylus. But, if the patient's stomach be weak,
he recommends milder laxatives. When the defluxion is of a phlegmatic,
that is to say, of a serous nature, he directs to give the active cathartics already
mentioned, especially hermodactylus; and, if it be the summer season, he ad-
vises also to give emetics. He cautions against using local applications of too
stimulant a nature at first, lest they dispel the more fluid parts of the defluxion
and leave the grosser behind. This is but a meagre sketch of his interesting
account of arthritic diseases. — Alsaharavius calls these complaints collections
of phlegm, bile, or blood. He holds that they are often hereditary. Like all
his countrymen, he a[)prov(>s of hermodactylus, which he gives in the form
COMMENTARY ON THB THIRD BOOK. 471
of pills, with myrobalans, colocynth, turbit, castor, opoponax, &c. When
fulness of blood is present, he directs to bleed.
The hermodactylus is recommended for the cure of arthritic diseases by the
earlier of the modern writers on medicine. See Lanfrancus, doc. ii. tr. 3.
Among the ancient treatises on gout, we have mentioned the tragi-comic
poem entitled Tragodopodagra, usually ascribed to the famous Lucian. It
ridicules, with much humour and severity, the many pretended nostrums for
this complaint. Among the remedial articles mentioned, I remark hellebore,
nitre (soda), henbane, poppy, fenugreek, and galls. The ridicule thus be-
stowed upon the use of specifics for the cure of a complaint so complicated
as goutj is no doubt well founded ; but we ought not to be deterred, by the ill
success of such a practice, from attempting to afford relief upon general
principles, as ably laid down by Alexander, Demetrius, and Haly Abbas.
I would fain impress upon the physician and his patient, that more than is
usually believed might be accomplished in all arthritic diseases, by correcting
the disorder of the digestive functions by means of a suitable diet and regimen ;
and that it is only when the constitution is radically unsound — when the
joints are deformed by concretions, and the vital powers have been worn out
by a long-continued course of debauchery — that we need adopt the discourag-
ing opinion of Ovid, as expressed in the following verse : —
'' Tollere nodosam nescit mediciaa podagram.*' Pont. i. el. 4.
Since writing the above, I have read Dr. Scudamore's ingenious treatise on
the gout; and it gives me much pleasure to remark, that the conclusions of
that distinguished physician respecting the nature and treatment of the dis-
ease are quite in accordance with those of Alexander and Demetrius. He
every where inculcates that gout arises from indigestion, and that the pro-
phylaxis and cure must be founded upon the principle of correcting this dis-
order of the stomach. The plethora in the system, he says, is sometimes
bilious, as indicated by an approach to jaundice; and sometimes sangui-
neous, the blood in this case being excessive in quantity and bad in quality.
For the latter he recommends venesection. The former species, he says, is
to be cured by emetics and purgatives. With regard to colchicum, he agrees
with the ancient authorities that it generally cuts short a paroxysm; but
that, being prejudicial to the stomach, it does not remove the constitu-
tional disorder. In order to effect a complete cure, he pointedly enjoins
the necessity of moderation as to eating, drinking, and sensual enjoyment.
As he attributes the disease, in a majority of cases, to the state of the liver,
he approves very much of cholagogues. He is rather undecided as to the
effects of cold applications, which were formerly recommended by Hippocrates,
and lately by Dr. Kinglake. He is unfavourable to the use of stimulant ap-
plications and moxa. He prefers a lotion of alcohol and camphor.
LXXIX. ON CHILBLAINS.
See Hippocrates, Epidem. vii. 38. — Celsus, v. 28. — ScriboniQs Largus,
c. 86. — Oribasius, Morh. Curat, iii. 56. — Octavius Horatianus, i. 28. —
Aetius, xiv. 73. — Actuarius, Meth. Med, vii. 8. — Nonnus,c. 224. — Avicenna,
lib. iii. fen. 22. tr. 2. and lib. iv. fen. 3. tr. 2. — Haly Abbas, Pract. iv. 17. —
Rhases, Divis, c. 125. — Alsaharavius, Pract. tr. xxix. § i. c. 27,
For these affections of the extremities Celsus recommends, in the first
place, to bathe them with hot water in which rapes or vervain have been
boiled. If ulceration has not taken place, copper, as hot as possible, is to be
applied to the part. If ulcerated, equal proportions of alum and frnnk-
4'^ 2 COMMBNTART ON THS THIRD BOOK.
incense, with wine, or pomegranate rind^ boiled in water and pounded, are
to be applied.
The following application, recommended by Scribonius, might be useful : —
g, Cerusss, lb. j. ; ol. myrtei, lb. j. ; Uthargyri, 3 xxiv. ; cerae Ponticae. lb. j.
Cerussa et spuma argenti coqauntur cum oleo, donee coeant, postea adjici-
tur cera.
For Pernio Aetius gives a long list of applications, several of which are
copied by our author. The ordinary ingredients of them are stimulants and
astringents. The following may be pointed out as likely to be useful : —
S> aluminis scissi, 3x.; lithargyri, 3iv. ; myrrhs, 3j.; ovorum albumina
duo ; vino et oleo myrteo, m, Aetius also gives a variety of prescriptions for
fissures and the other complaints of the feet.
The turnip is mentioned by Pliny as an application to chilbains. See also
Galen, de Optima Secta, c. 16. It is still a popular remedy for them in the
north of Scotland.
Octavius Iloratianus lays down very judicious rules for the treatment of
these complaints. His applications, however, are much the same as our
author's. Thus, for chilblains he recommends fomentations with salt water,
or the decoction of beet, containing also alum ; after which the part is to be
anointed with melted wax. He also mentions, as proper applications, galls
poundedwith vinegar ; a mixture of wax and melted pitch ; a cataplasm of
Doiled lentils; the grease of geese, with wax and oil, applied in a tepid state;
and the like. When ulcerated, he directs to apply an ointment of litharge
and axunge. For fissures he particularly recommends liquid pitch; or
litharge mixed with ceruse, alum, and wine. When hairs are troublesome
they are to be cleared away with a fine piece of iron.
For fissures Rhases recommends the fat of a cock with galls. Alsahara-
vius lays down the rul^s for treating chilblains in all their stages with great
precision. If the parts become red or black, he recommends to make deep
scarifications with a scalpel ; after which the foot is to be put into hot water
and allowed to bleed freely. His dressings are similar to those of the others.
Ilaly's treatment is like our author's.
LXXX. ON CORNS AND CALLOUS IfLBSH.
Aetius delivers the treatment of Corns fully ; but his remedies, although
similar to those of our author, are not of such ready application.
Celsus says that, by simply paring corns, the part may often be softened.
Afterwards rosin mixed with a small quantity of the lapis molaris may be
applied.
Avicenna states that, when the disease is not cured, it may end in Cancer.
Marcellus directs to pare corns, and apply to them a composition of arsenic
and turpentine rosin.
For corns Rhases recommends a composition of red arsenic, quicklime,
quicksilver killed, with the ashes of acorns (impure potash 1) and oil. He
also joins Galen in recommending a composition of cantharides and arsenic.
For the Callus he directs to use the juice of figs and of spurge. — Continens,
lib. xxxvi.
LXXXI. — ON COMPLAINTS ABOUT THB NAILS ; AND, FIRST, OF
WHITLOW.
See most of the authorities referred to in the Seventy-ninth Chapter.
Aetius and Oribasius treat Whitlow upon the same plan as our author,
namely, by using cooling and astringent applications, such as galls, alum,
COMMENTARY ON THE THIRD BOOK. 473
and pomegranate rind at the commencement ; and, after it has burst, and
fungous flesh has got up, by applying strong caustic and corrosive medicines,
such as arsenic, verdigris, quicklime, and the flakes of copper. Neither of
these authors, however, say any thing about making an early incision of the
part afl'ected with whitlow, which must be considered a defect in their me-
thod of prdctice. Octavius Horatianus, however, seems to have had it in
view to recommend an early opening, when he says — *^ Si saniem san^ coUe-
gerit, locum pungis." In fact, it is as soon as the part becomes gorged with
blood, and before the matter has had time to be properly formed, that an
opening should be made.
Avicenna is exceedingly minute in his directions for treating whitlow. He
recommends at flrst to put the flnger into hot vinegar. Then various astringent
and repellent applications are to be used, among other ingredients contain-
ing camphor. These are afterwards to be changed for emollient and sedative
applications prepared with opium. When matter forms, it is to be let out
by a small opening. Haly Abbas directs at first to apply the seed of flea-
wort pounded in vinegar, or snow, to cool and deaden the sensibility of the
part. When these do not answer, he advises to use suppurative applica-
tions; and, when the abscess does not open readily, he directs to mdce an
incision with the edge of a lancet. When the pain is violent and obstinate,
he recommends to add opium, henbane, and vinegar to the applications.
He mentions that Hippocrates recommends an application of galls and vine-
gar for whitlow. Alsaharavius describes whitlow by the name of Alcahas,
He recommends to bleed at the commencement, then to use a plaster of vi-
negar and opium, or a piece of cloth wet in snow or cold water, and fre-
quently changed, or to put the flnger into hot oil. If these means do not
succeed, suppuration is to be encouraged ; and, as soon as matter forms, it is
to be let out. Avenzoar describes a species of malignant whitlow, of which
I have seen some few cases. He says it spreads up the hand, and oc-
casions corruption of it. He recommends free incision, and relates a case
in which very bad effects resulted from neglecting this practice. — See lib. iii.
tr. 2., c. 37. This is perhaps the same disease that is described by Alsaha-
ravius, Pract. tr. xxix. § 1. c. 25., and, by Albucasis, Chirurg. c. 1.
Rhases says that the common people put the flnger into hot oil. He also
recommends hot vinegar and hot water.— Cow^tucTW, lib. xxxvi.
Heister recomipends hot camphorated spirits, or hot vinegar, or hot
water, at the commencement of whitlow. This is very like Avicenna*s
practice. It is also mentioned by Glandorpius in his learned Tract on Pa-
ronychia. Guy of Cauliac, and the authorities of that age, recommend the
refrigerant mode of treatment at the commencement. Glandorpius properly
directs to make an early opening.
Celsus directs to make an opening around scabrous nails, and then to ap-
ply a composition consisting of red arsenic, nitre, common arsenic, and
liquid pitch. Under the use of this application, the diseased nails fall off and
healthy ones come in their place. Haly Abbas and Alsaharavius also re-
commend applications containing arsenic. Alexander Aphrodisieus mentions
that Leuce occurs more commonly on the hands than the feet, and in child-
ren rather than in adults. This arises, he says, from the feet being more ex-
ercised than the hands, and from children eating more voraciously than
adults — Problem, i. 146. The compositions recommended in the Euporiston
of Dioscorides for leprous nails are, arsenic and water, sandarach, quicklime,
and burnt lees of wine with pitch, the juice of thapsia and mustard with
vinegar, &c.
For Bruised Nails, Aetius strongly commends a mixture of fossil salt
with water and oil. Avenzoar speaks of privet (alcanna) with olive oil.
For Bloody Nails, Nonnus recommends a mixture of verdigris and ax-
unge.
474 COMMENTARY ON THE THIRD BOOK.
Avicenna, among other applications resembling those of the Greeks, recom-
mends a plaster of cypress-nuts, and savin.
¥or Pterygia, Celsus, among other applications, makes mention of a
mixture of arsenic, quicklime, and chalcitis, in equal proportions. If this
application fail, he directs to use the Actual Cautery. Aetius and Oribasius
recommend the most powerful escharotics, such as verdigris, misy, sori,
chalcitis, and arsenic. These applications are mentioned likewise by Rhases,
Confinem, lib. xxxvi.
Pliny says of arsenic : — "Tollit et pterygia Digitorum," &c.--//. N, xxxiv.
56.
Mr. Aberiiethy, in his Surgical Lectures, gives an account of a peculiar
class of ulcers which occur about the nails, and get better under the use of
arsenic. I presume he alludes to the pterygia, for the cure of which
arsenic was freely used by the ancients.
Primed by U. Cornwall, Aberdeen Heratd Office.
CORRIGENDA.
For bloodwort,^<w«..««^ read knot-grass, page 7> twenty-first line from the foot.
,, effusion, ^^.^ „ affasion, p. 127. fifth line from the top.
,, locally, ^ — ^^^^^ „ gradually, p. 131. tenth' line from the foot.
,, of a violet colour,-* „ of a verdigris green colour, p. 146. twenty-third
line from the top.
ne, ^^^ — ^^. ,, nse, p. 182. fifth line from the top.
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